Individual provider Active NPI

Nagraj Narasimhan, M.D.

  • Nephrology Physician
  • Twin Falls, ID
National Provider Identifier
1063449221
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
M5063 Issued in ID
Practice address
350 N Haven Dr
Twin Falls, ID 83301-5788
Phone
(208) 904-4780
Fax
(208) 904-4832
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X M5063 ID Primary

Addresses

Primary practice location

350 N Haven Dr
Twin Falls, ID 83301-5788

Mailing address

PO Box 268934
Oklahoma City, OK 73126-8934
Phone (208) 904-4780

Other identifiers 2

IdentifierTypeStateIssuer
P00431118OtherIDRR MEDICARE
001835200MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5063IDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nagrajnarasimhan@ikillp.allscriptsdirect.net

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1063449221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268934",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268934",
            "telephone_number": "208-904-4780",
            "fax_number": "208-904-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N HAVEN DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015788",
            "telephone_number": "208-904-4780",
            "fax_number": "208-904-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARASIMHAN",
        "first_name": "NAGRAJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ID",
            "license": "M5063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00431118",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001835200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.