Dr Thiyagu Ganesan, MD is a medicare enrolled "Pediatrics" physician in Marysville, California. His current practice location is
5730 Packard Avenue, Suite No: 500, Marysville, California. You can reach out to his office (for appointments etc.) via phone at
(530) 749-3242.
Dr Thiyagu Ganesan is licensed to practice in California (license number A140735) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508204009.
Physician's Profile
| Full Name | Dr Thiyagu Ganesan |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 5730 Packard Avenue, Marysville, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1508204009
- Provider Enumeration Date: 06/06/2013
- Last Update Date: 10/24/2016
Medicare PECOS Information:
- PECOS PAC ID: 5294021655
- Enrollment ID: I20170217000494
Medical Identifiers
Medical identifiers for Dr Thiyagu Ganesan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1508204009 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | A140735 (California) | Primary |
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. Dr Thiyagu Ganesan allows following entities to bill medicare on his behalf.
| Entity Name | Ampla Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952333635
PECOS PAC ID: 5092619270
Enrollment ID: O20040225001116 |
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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. Dr Thiyagu Ganesan 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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Dr Thiyagu Ganesan, MD
5730 Packard Ave, Suite 500,
Marysville, CA 95901-7118
Ph: (530) 749-3242 | Dr Thiyagu Ganesan, MD
5730 Packard Avenue, Suite No: 500,
Marysville, CA 95993
Ph: (530) 749-3242 |
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