Prakash N Puranik, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

022155 Issued in CT

Practice address

546 S Broad St
Unit 2 E
Meriden, CT 06450-6600

Phone

(203) 237-1054

NPI assigned

Apr 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ECCCBA
• Direct secure messaging: prakashpuranik2@arh.medalliesdirect.net

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.

• Hartford Healthcare Medical Group, Inc

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301
  Medicare reassignment
• Family and Internal Medicine of Dixwell Avenue

  • Internal Medicine Physician
  • Hamden, CT
  • NPI 1962681684
  NPD (past)
• Family Practice & Internal Medicine of Spring Gren LLC

  • Internal Medicine Physician
  • Hamdeh, CT
  • NPI 1255371571
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1164489860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 S BROAD ST",
            "address_2": "UNIT 2 E",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506600",
            "telephone_number": "203-237-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 S BROAD ST",
            "address_2": "UNIT 2 E",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506600",
            "telephone_number": "203-237-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURANIK",
        "first_name": "PRAKASH",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "022155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001221555",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Eyecare of Meriden LLC.
• James Price
• Laura Prior, APRN
• Diane H Puppolo, APRN
• Puranik Family Medical Center LLC
• Lila Mae Purvis
• Paul Pyo, M.D.
• Erica Lauren Quinones, DMD
• Junibeth Quinones, LMFT
• Dellene W Quintiliani, LCSW

• Internal Medicine Physician in Meriden, CT
• Providers in Meriden, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.

Verify at the official NPI Registry.