Individual provider Active NPI

Dhivya Rengan Kannabiran, M.D.

  • Obstetrics & Gynecology Physician
  • Worcester, MA
National Provider Identifier
1891006185
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
267700 Issued in MA
Practice address
33 Kendall St
Worcester, MA 01605-2726
Phone
(508) 334-6255
Fax
(508) 334-6063
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 267700 MA Primary
Obstetrics & Gynecology Physician 207V00000X MT197656 PA

Addresses

Primary practice location

33 Kendall St
Worcester, MA 01605-2726

Mailing address

PO Box 415348
Boston, MA 02241-5348

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Direct Messaging Address dkannabiran31639@UmassMemorial.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161110002260 MA Practitioner - Obstetrics/Gynecology 4789803156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Massachusetts Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000

281 Lincoln St
Worcester, MA 01605-2138
Phone (508) 334-1000

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
267700MAMDObstetrics & Gynecology Physician
MT197656PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Sep 26, 2016 Accepting new patients
Umass Memorial Medical Group Inc Obstetrics & Gynecology CurrentSince Sep 26, 2016 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

33 Kendall St
Worcester, MA 01605
Phone (508) 334-6255

Interoperability endpoints

  • Direct secure messaging: dkannabiran31639@umassmemorial.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1891006185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 KENDALL ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052726",
            "telephone_number": "508-334-6255",
            "fax_number": "508-334-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNABIRAN",
        "first_name": "DHIVYA",
        "middle_name": "RENGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "267700",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT197656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "33 Kendall St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkannabiran31639@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "33 Kendall St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.