Active NPI
Arvind Vasant Panchoo, M.D.
- Pediatric Gastroenterology Physician
- Miami, FL
National Provider Identifier
1073977765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 331065
- Practice address
- 1611 NW 12TH Avenue
Miami, FL 33136 - Phone
- (305) 585-6042
- Fax
- (305) 545-6018
- NPI assigned
- Apr 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Gastroenterology Physician | 2080P0206X | 331065 | LA | Primary |
Addresses
Primary practice location
1611 NW 12TH Avenue
Miami, FL 33136
Mailing address
2956 Meadow Grove Ave
Zachary, LA 70791-5478
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | apanchoo4162138@direct.casso.us.com | Direct | |
| FHIR URL | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Other |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1073977765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2956 MEADOW GROVE AVE",
"city": "ZACHARY",
"state": "LA",
"postal_code": "707915478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVENUE",
"city": "MIAMI",
"state": "FL",
"postal_code": "33136",
"telephone_number": "305-585-6042",
"fax_number": "305-545-6018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANCHOO",
"first_name": "ARVIND",
"middle_name": "VASANT",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-08",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "LA",
"license": "331065",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "apanchoo4162138@direct.casso.us.com",
"affiliation": "N",
"endpointDescription": "FMOLHS-Epic",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "apanchoo4162138@direct.casso.us.com",
"address_1": "8200 Constantin Blvd Fl 4",
"city": "Baton Rouge",
"state": "LA",
"country_code": "US",
"postal_code": "708093481",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FMOLHS FHIR URL",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "8200 Constantin Blvd Fl 4",
"city": "Baton Rouge",
"state": "LA",
"country_code": "US",
"postal_code": "708093481",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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- Armando Manuel Pancorbo Arencibia, M.D.
- Cristobal Pancorbo Madrigal, CSA
- Dario Pancorbo, MD
- Elizabeth Laura Pancorbo, APRN
- Juan Pablo Pancorbo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.