Surianarayanan Ambalavanan, MD is a medicare enrolled "Otolaryngology" physician in Celina, Ohio. He graduated from medical school in 1978 and has 47 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Jtdm Family Practice Llc and his current practice location is
801 Pro Dr Ste D4, Vanan Ent & Sinus Center, Celina, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 586-6480.
Surianarayanan Ambalavanan is licensed to practice in Ohio (license number 35-090880) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1922061910.
Physician's Profile
| Full Name | Surianarayanan Ambalavanan |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Experience | 47 Years |
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| Location | 801 Pro Dr Ste D4, Celina, Ohio |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Surianarayanan Ambalavanan graduated from medical school in 1978
NPI Data:
- NPI Number: 1922061910
- Provider Enumeration Date: 04/10/2006
- Last Update Date: 08/05/2020
Medicare PECOS Information:
- PECOS PAC ID: 3971531393
- Enrollment ID: I20080327000083
Medical Identifiers
Medical identifiers for Surianarayanan Ambalavanan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922061910 | NPI | - | NPPES |
| 2820755 | Medicaid | OH | |
| 1184652539 | Other | OH | GROUP NPI |
| 9934723 | Other | OH | MEDICARE GROUP PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Y00000X | Otolaryngology | 35-090880 (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Jtdm Family Practice Llc | 2163415837 | 43 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Surianarayanan Ambalavanan allows following entities to bill medicare on his behalf.
| Entity Name | Jtdm Family Practice Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184652539
PECOS PAC ID: 2163415837
Enrollment ID: O20040407000863 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Surianarayanan Ambalavanan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Surianarayanan Ambalavanan, MD
200 Saint Clair Ave, Jtdm Family Practice Llc,
Saint Marys, OH 45885-2400
Ph: (419) 394-3387 | Surianarayanan Ambalavanan, MD
801 Pro Dr Ste D4, Vanan Ent & Sinus Center,
Celina, OH 45822-3307
Ph: (419) 586-6480 |
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