Shanmugham Vadivelu, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01060743A Issued in IN

Practice address

1507 Wabash St
Suite 400C
Michigan City, IN 46360-4300

Phone

(219) 871-0833

Fax

(219) 871-0836

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lakeshore Interventional Pain Associates, LLC

  • Specialist
  • Michigan City, IN
  • NPI 1386823540
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902806193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 WABASH ST",
            "address_2": "SUITE 400C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604300",
            "telephone_number": "219-871-0833",
            "fax_number": "219-871-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 WABASH ST",
            "address_2": "SUITE 400C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604300",
            "telephone_number": "219-871-0833",
            "fax_number": "219-871-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADIVELU",
        "first_name": "SHANMUGHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01060743A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000366517",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard C. Turk, DO
• Laura E Tylisz
• Mary O Ubanwa, MD
• Rhonda Lynn Underwood, MA, NCC, LMHC
• Usv Optical Inc.
• Valerie Haughtington, DDS PC
• Carolyn M Valois, PA-C
• Lane Scott Van Sickle, NP
• Megan Marie Vaness, DPT
• Lisa Varnado

• Anesthesiology Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.