Individual provider Active NPI

Suman Kumar Das, MD

  • Plastic and Reconstructive Surgery Physician
  • Flowood, MS
National Provider Identifier
1164511374
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
10570 Issued in MS
Practice address
2629 Courthouse Cir
Flowood, MS 39232-9521
Phone
(601) 362-0611
Fax
(601) 362-0192
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 10570 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

2629 Courthouse Cir
Flowood, MS 39232-9521

Mailing address

2629 Courthouse Cir
Flowood, MS 39232-9521
Phone (601) 362-0611

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
08922816MedicaidMS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 16, 2020.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1164511374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 COURTHOUSE CIR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329521",
            "telephone_number": "601-362-0611",
            "fax_number": "601-362-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 COURTHOUSE CIR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329521",
            "telephone_number": "601-362-0611",
            "fax_number": "601-362-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "SUMAN",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MS",
            "license": "10570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08922816",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.