KIAME JACKSON MAHANIAH (MD) – Family Medicine Physician, NPI 1790771756

KIAME JACKSON MAHANIAH (MD) is a healthcare provider. based in Salem, Massachusetts. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 219111 (MA). The NPI Number for KIAME JACKSON MAHANIAH (MD) is 1790771756

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
KIAME JACKSON MAHANIAH (MD)
NPI
1790771756
Phone
(978) 744-8388
Address
47 CONGRESS ST
Enumeration Date
26 September 2005
Last Update Date
20 July 2012

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
9592167305
Graduation Year
1997 (29 years ago)
PAC ID
8123911799
Group Practice PAC ID
0042217507
Professional Enrollment ID
I20040206000166
Address ID
MA019011314LY269XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,899 FAMILY PRACTICE in MA

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Provider Addresses for KIAME JACKSON MAHANIAH (MD)

  • 29;33;35;45;47, Congress Street, The Point, South Salem, Salem, Essex County, Massachusetts, 01970, United States

    SALEM, MA 019707308

    Phone: (978) 744-8388

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-02-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040206000166IFamily PracticeMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
83036Hemoglobin a1c level4948$0
View full utilization report →

Insurance plans in this area (ZIP 01970)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042217507View full group profile
NameSpecialtyState
Physician AssistantMA
-MA
-MA
Family PracticeMA
Family PracticeMA
Clinical Social WorkerMA
Nurse PractitionerMA
Mental Health CounselorMA
Physician AssistantMA
Family PracticePA

Reviews

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Frequently asked questions

What NPI should I save for KIAME JACKSON MAHANIAH (MD)?
Save NPI 1790771756 if you need a stable reference for KIAME JACKSON MAHANIAH (MD).
Does this profile mean KIAME JACKSON MAHANIAH (MD) is currently active?
Yes — KIAME JACKSON MAHANIAH (MD) appears active in the national provider directory.
Does KIAME JACKSON MAHANIAH (MD) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for KIAME JACKSON MAHANIAH (MD). Clinical services aligned with this taxonomy classification.
Where is KIAME JACKSON MAHANIAH (MD)'s primary listing?
We display Salem, Massachusetts because that is what the record indicates for KIAME JACKSON MAHANIAH (MD).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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