Souroush Mohammed Niknahad, SRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1149312 Issued in KY

Practice address

200 Abraham Flexner Way
Louisville, KY 40202-2877

Phone

(502) 587-4404

NPI assigned

Nov 8, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Louisville Physicians IncGroup PAC ID 3476725599, 1,438 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Louisville Hospital Hospital, Louisville, KY, CCN 180141

Medicare enrollment (NPD)

Enrolled

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 Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316
  Medicare reassignment Care Compare group NPD
• University of Louisville Physicians, Inc.

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD
• University of Louisville Physicians, Inc.

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1386990232
  NPD

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

• University Medical Center, Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1861554438
  Care Compare affiliation

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1164296331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022877",
            "telephone_number": "502-587-4404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021675",
            "country_code": "US",
            "telephone_number": "502-562-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKNAHAD",
        "first_name": "SOUROUSH",
        "middle_name": "MOHAMMED",
        "credential": "SRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1149312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nigisti Hismith Ministries, Inc.
• Nigisti Hismith Ministries, Inc.
• Nigisti Hismith Ministries, Inc.
• Amanuel A Nigusse, PHARMD
• Komal Nijjer
• Samuel S Nikolich
• Nikorb Healthcare, LLC
• Nikorb Medical Services LLC
• Rebecca Lynn Niksich, AUD
• Georgia Ann Niles, ARNP

• Certified Registered Nurse Anesthetist in Louisville, KY
• Providers in Louisville, KY by specialty
• Certified Registered Nurse Anesthetist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.