SURIANARAYANAN AMBALAVANAN, MD — NPI 1922061910 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1922061910

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207Y00000X (CMS 04)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology

Box 32 Service Location & ZIP+4

801 PRO DR STE D4, VANAN ENT & SINUS CENTER, CELINA, OH, 45822-3307

✓ 9-Digit EDI 837 ZIP+4 (45822-3307)

Practice Phone & Referral Fax

(419) 586-6480

Fax: (419) 586-8509

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922061910 (SURIANARAYANAN AMBALAVANAN, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1922061910` (NPI-1 Individual Practitioner)
Provider / Legal Name	SURIANARAYANAN AMBALAVANAN, MD
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology NUCC Code: `207Y00000X` (Otolaryngology)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	801 PRO DR STE D4, VANAN ENT & SINUS CENTER, CELINA, OH, 45822-3307
Practice Telephone / Fax	Tel: (419) 586-6480 \| Fax: (419) 586-8509
Administrative Mailing Address	200 SAINT CLAIR AVE, SAINT MARYS, OH, 45885-2400
Enumeration & Last Sync	Enumerated: 2006-04-10 \| CMS Record Updated: 2020-08-05

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

801 PRO DR STE D4, VANAN ENT & SINUS CENTER, CELINA, OH, 45822-3307

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Plain-English Taxonomy & CMS Crosswalk (207Y00000X)

What Does Taxonomy Code 207Y00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Y00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 04 (Physician/Otolaryngology)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Otolaryngology for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SURIANARAYANAN AMBALAVANAN, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207Y00000X` — Otolaryngology Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology	State: OH \| License: `35-090880` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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SURIANARAYANAN AMBALAVANAN, MD (NPI #1922061910)