Individual provider Active NPI

Madhan Nellaiyappan, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Vancouver, WA
National Provider Identifier
1932515103
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD61229890 Issued in WA
Practice address
200 NE Mother Joseph PL Ste 400
Vancouver, WA 98664-3290
Phone
(360) 514-4444
Fax
(360) 514-6530
NPI assigned
Jul 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT207083 PA
Clinical Cardiac Electrophysiology Physician 207RC0001X MD61229890 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph PL Ste 400
Vancouver, WA 98664-3290

Mailing address

320 East North Avenue, Allegheny General Hospital,
Pittsburgh, PA 15212-4772

Other practice location 1

320 East North Avenue,Allegheny General Hospital,
Pittsburgh, PA 15212-4772
Phone (412) 359-4971

Other practice location 2

2312 NE 129th St
Vancouver, WA 98686-3236
Phone (360) 514-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220920003108 WA Practitioner - Cardiac Electrophysiology 6901184498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9739092065, 101 clinicians

Practice addresses (Care Compare)

200 NE Mother Joseph PL
Suite 400
Vancouver, WA 98664-3290
Phone (360) 256-2640

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Sep 19, 2022 Accepting new patients
Peacehealth CurrentSince Sep 19, 2022 Accepting new patients

Locations

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

200 NE Mother Joseph Pl
Ste 400
Vancouver, WA 98664
Phone (360) 256-2640

2312 NE 129th St
Vancouver, WA 98686
Phone (360) 546-8950

Interoperability endpoints

  • Direct secure messaging: mnellaiyappan563709@direct.peacehealth.org

Organizations & group practices 2

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 5

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1932515103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAST NORTH AVENUE, ALLEGHENY GENERAL HOSPITAL,",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 400",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643290",
            "telephone_number": "360-514-4444",
            "fax_number": "360-514-6530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 East North Avenue,Allegheny General Hospital,",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152124772",
            "country_code": "US",
            "telephone_number": "412-359-4971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2312 NE 129th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986863236",
            "country_code": "US",
            "telephone_number": "360-514-4444",
            "fax_number": "360-514-6530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELLAIYAPPAN",
        "first_name": "MADHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT207083",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WA",
            "license": "MD61229890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.