Active NPI
Pakorn Urusopone, M.D.
- Anesthesiology Physician
- Indianapolis, IN
National Provider Identifier
1114080371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01051441A
- Practice address
- 1481 W 10TH St
Indianapolis, IN 46202-2803 - Phone
- (317) 988-2475
- Fax
- (317) 988-2477
- NPI assigned
- Dec 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01051441A | IN | Primary |
Addresses
Primary practice location
1481 W 10TH St
Indianapolis, IN 46202-2803
Mailing address
7138 Chesterton LN
Indianapolis, IN 46237-8308
Phone (317) 865-8944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01051441A | IN | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114080371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7138 CHESTERTON LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462378308",
"telephone_number": "317-865-8944",
"fax_number": "317-988-2477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1481 W 10TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022803",
"telephone_number": "317-988-2475",
"fax_number": "317-988-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URUSOPONE",
"first_name": "PAKORN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01051441A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.