Individual provider Active NPI

Kalpana Changa Tyagaraj, MD

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1033157987
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
197436 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2844
Phone
(718) 283-8816
NPI assigned
Jun 3, 2006
Last updated
Jun 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 197436 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2844

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (800) 242-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070711000108 NY Practitioner - Anesthesiology 3870693591 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197436NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
CMC Housestaff Past Accepting new patients
American Anesthesia Business Partners, LLP PastSince Oct 21, 2025 Accepting new patients
University Group Medical Associates, P.C Anesthesiology Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Maimonides Department of Psychiatry FPP Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

Interoperability endpoints

  • Direct secure messaging: kalpanatyagaraj@mai.allscriptsdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1033157987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-242-1131",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192844",
            "telephone_number": "718-283-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYAGARAJ",
        "first_name": "KALPANA",
        "middle_name": "CHANGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "197436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.