POKALA R KIRAN MD, NPI 1871798330 — NEW YORK (NY)

NPI 1871798330

12+ Years Experience Individual

POKALA R KIRAN MD

06/15/2007
PROVIDER ENUMERATION DATE
04/24/2018
LAST UPDATE DATE
1871798330
NPI NUMBER

About POKALA R KIRAN

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

POKALA R KIRAN is a provider established in NEW YORK, NY. The NPI number of POKALA R KIRAN is 1871798330 and was assigned on 06/15/2007. The practitioners primary taxonomy code is: 208C00000X with license number: 269812-1 NY .

Mailing address

  • City: NEW YORK
  • State: NY
  • Postal code: 100323729
  • Phone: 2123421155
  • Fax: 2123050267
  • Address: 161 FORT WASHINGTON AVE FL 8

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1871798330
  • Phone : 2123421161
  • Fax : 2123050267
  • Postalcode : 100323729
  • Address : 161 FORT WASHINGTON AVE FL 8

Additional identifiers

  • Identifier: 2751820
  • Code / Type : 5 - MEDICAID
  • Identifier state : OH

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 3590801
  • Code / Type : 5 - MEDICAID
  • Identifier state : NY

Provider taxonomy - Colon & Rectal Surgery

  • Taxonomy code: 208C00000X
  • License number: 269812-1
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

Contacts:

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  • POKALA R KIRAN MD
  • Address : 161 FORT WASHINGTON AVE FL 8
  • Region : NEW YORK, NY
  • NPI : 1871798330
  • Phone : 2123421161
  • Fax : 2123050267
  • Postalcode : 100323729

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address161 FORT WASHINGTON AVE FL 8
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNEW YORK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code100323729
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2123421161
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2123050267
The fax number associated with the location address of the provider being identified.
NPI1871798330
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1208C00000X
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Provider Enumeration Date06/15/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/24/2018
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)POKALA R KIRAN
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address161 FORT WASHINGTON AVE FL 8
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameNEW YORK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code100323729
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2123421155
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2123050267
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1208C00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Colon & Rectal Surgery
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Provider License Number 1269812-1
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 12751820
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1OH
Other Provider Identifier State #1
Other Provider Identifier 23590801
Other Provider Identifier #2
Other Provider Identifier Type 25
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2NY
Other Provider Identifier State #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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