Pavana Naga Gopi Krishna Tirumanisetti, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-13165 Issued in AR

Practice address

1601 W 40TH Ave
Pine Bluff, AR 71603-6069

Phone

(870) 541-6000

Fax

(870) 541-6009

NPI assigned

Aug 27, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Central Primary Care PLLCGroup PAC ID 8729142682, 22 clinicians

University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Homecare Home health agency, White Hall, AR, CCN 047093
• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
• University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1831144120
  Medicare reassignment Care Compare group NPD
• Arkansas Central Primary Care, PLLC

  dba Jacksonville Medical Care

  • Family Medicine Physician
  • Jacksonville, AR
  • NPI 1396996740
  Medicare reassignment Care Compare group
• Arkansas Emergency Staffing Solutions, Inc

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1275774630
  Medicare reassignment NPD
• Ess Hospitalist LLC

  • Hospitalist Physician
  • Crossett, AR
  • NPI 1881967305
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016

  Family Medicine

  NPD (past)
• St Francis Medical Center, Inc

  • Rehabilitation Hospital Unit
  • Monroe, LA
  • NPI 1013906239
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Hospital Association Inc

  dba Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation
• Jefferson Regional Homecare, LLC

  dba Jefferson HomeCare

  • Home Health Agency
  • White Hall, AR
  • NPI 1891972642
  Care Compare affiliation
• University of Arkansas for Medical Sciences

  dba The University Hospital of Arkansas

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1477549756
  Care Compare affiliation

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1083920086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 W 8TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722042029",
            "telephone_number": "501-686-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6000",
            "fax_number": "870-541-6009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2408 Broadmoor Blvd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712012963",
            "country_code": "US",
            "telephone_number": "318-807-0525",
            "fax_number": "318-807-1077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2408 Broadmoor Blvd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712012963",
            "country_code": "US",
            "telephone_number": "318-807-0525",
            "fax_number": "318-807-1077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712017407",
            "country_code": "US",
            "telephone_number": "318-966-4541",
            "fax_number": "318-966-4543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIRUMANISETTI",
        "first_name": "PAVANA NAGA",
        "middle_name": "GOPI KRISHNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "206188",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "206188",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-13165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2118013",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kentavia Thompson
• Peggy Ann Thompson, RN
• Samuel Jabary Thompson
• Ramakrishna Thotakura
• John P Thrash, D.P.M.
• Alisha Todd, OTR.L
• Marious Tolbert, LPC
• Tommy V. Ray Jr Inc
• Drew William Toole, DDS
• Torrance a Walker MD PA

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.