Individual provider Active NPI

Thiruvengadam Kulasekaran, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Akron, OH
National Provider Identifier
1013991843
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
35046455K Issued in OH
Practice address
300 Locust St
Suite 150
Akron, OH 44302-1821
Phone
(330) 253-2113
Fax
(330) 253-2362
NPI assigned
Dec 5, 2005
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 35046455K OH Primary

Addresses

Primary practice location

300 Locust St
Suite 150
Akron, OH 44302-1821

Mailing address

300 Locust St
Suite 150
Akron, OH 44302-1821
Phone (330) 253-2113

Other identifiers 1

IdentifierTypeStateIssuer
0468533MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110606000447 OH Practitioner - Neurology 6800071796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35046455KOHMDNeurology with Special Qualifications in Child Neurology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1013991843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LOCUST ST",
            "address_2": "SUITE 150",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443021821",
            "telephone_number": "330-253-2113",
            "fax_number": "330-253-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LOCUST ST",
            "address_2": "SUITE 150",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443021821",
            "telephone_number": "330-253-2113",
            "fax_number": "330-253-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULASEKARAN",
        "first_name": "THIRUVENGADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OH",
            "license": "35046455K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.