Individual provider Active NPI

Indranil Chakraborty, MD

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1164522082
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-4315 Issued in AR
Practice address
4301 W Markham St #783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 526-6562
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-4315 AR Primary

Addresses

Primary practice location

4301 W Markham St #783
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St #783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 5

IdentifierTypeStateIssuer
5N445OtherARBCBS
160491001MedicaidAR
E4315OtherARTRICARE
P00350630OtherARRAILROAD MEDICARE 1
06070015300OtherARQUALCHOICE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060511000140 AR Practitioner - Anesthesiology 6608899901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Hospital & facility affiliations

  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-4315ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Anesthesiology CurrentSince Mar 24, 2005 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Mar 24, 2005 Accepting new patients

Locations

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1164522082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST #783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST #783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRABORTY",
        "first_name": "INDRANIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-4315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5N445",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160491001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "E4315",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE 1",
            "identifier": "P00350630",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "06070015300",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.