Individual provider Active NPI

Kandamurugu Manickam, MD

  • Clinical Genetics (M.D.) Physician
  • Columbus, OH
National Provider Identifier
1972712743
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
35-092399 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-3538
Fax
(614) 722-3546
NPI assigned
May 21, 2007
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 35-092399 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 1

2222 Cherry St Ste 2600
Toledo, OH 43608-2675
Phone (419) 251-8015

Other practice location 2

26 Hospital Dr
Athens, OH 45701-2471
Phone (614) 722-2000

Other practice location 3

555 S 18th St
Columbus, OH 43205-2654
Phone (614) 722-6200

Other practice location 4

500 S Cleveland Ave
Westerville, OH 43081-8971
Phone (614) 722-2000

Other practice location 5

7901 Diley Rd
Canal Winchester, OH 43110-9612
Phone (614) 722-2000

Other practice location 6

730 W Market St
Lima, OH 45801-4602
Phone (614) 722-6200

Other practice location 7

278 W Union St
Athens, OH 45701-2310
Phone (614) 722-6200

Other practice location 8

5665 Venture Dr
Dublin, OH 43017-2159
Phone (614) 722-6200

Other practice location 9

410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 722-2000

Other practice location 10

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-2000

Other practice location 11

380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone (614) 722-2000

Other practice location 12

2213 Cherry St
Toledo, OH 43608-2603
Phone (419) 251-8015

Other practice location 13

740 Adair Ave
Zanesville, OH 43701-2838
Phone (614) 722-2000

Other identifiers 2

IdentifierTypeStateIssuer
2875143MedicaidOH
4250173OtherOHCGS - MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090114000172 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2769545912 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Nisonger CenterGroup PAC ID 5698796456, 5 clinicians

Practice addresses (Care Compare)

1581 Dodd Dr
Columbus, OH 43210-1257
Phone (614) 685-6701

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-092399OHMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Pediatric Academic Association, Inc. CurrentSince Feb 20, 2010 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Feb 1, 2021 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Feb 1, 2021 Accepting new patients
Osu Nisonger Center CurrentSince Feb 19, 2022 Accepting new patients
Nationwide Children's Hospital CurrentSince Sep 2, 2024 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Nationwide Children's Hospital CurrentSince Sep 2, 2024 Accepting new patients
Northwest Pediatric Specialists, LLC CurrentSince Apr 26, 2023 Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

26 Hospital Dr
Athens, OH 45701
Phone (614) 722-2530

278 W Union St
Athens, OH 45701
Phone (740) 592-4431

7901 Diley Rd
Canal Winchester, OH 43110
Phone (614) 355-9050

Dept L289
Columbus, OH 43260

456 W 10th Ave
Columbus, OH 43210
Phone (614) 293-8015

1581 Dodd Dr
Columbus, OH 43210
Phone (614) 293-2101

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

380 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 355-0569

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

5665 Venture Dr
Dublin, OH 43017
Phone (614) 355-8480

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2222 Cherry St
Toledo, OH 43608
Phone (419) 251-4200

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2222 Cherry St
Ste 2600
Toledo, OH 43608
Phone (419) 251-8005

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

500 S Cleveland Ave
Westerville, OH 43081
Phone (380) 898-4000

740 Adair Ave
Zanesville, OH 43701
Phone (614) 722-3535

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
  • Direct secure messaging: kmanickam843693@direct.bsmhealth.org
  • FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1972712743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-3538",
            "fax_number": "614-722-3546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Cherry St Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082675",
            "country_code": "US",
            "telephone_number": "419-251-8015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012471",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430818971",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Diley Rd",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109612",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 W Market St",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458014602",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "278 W Union St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012310",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5665 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432157508",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "419-251-8015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 Adair Ave",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437012838",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANICKAM",
        "first_name": "KANDAMURUGU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "OH",
            "license": "35-092399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2875143",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS - MEDICARE",
            "identifier": "4250173",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.