Nikhil Vaishnav Tirukkovalur, MBBS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

999999 Issued in MO

Practice address

1402 S Grand Blvd
Saint Louis, MO 63104-1004

Phone

(314) 617-3811

NPI assigned

Mar 24, 2025

Sex

Male

Sole proprietor

No

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 MO

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

State licenses

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1174324016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 SHADY AVE APT 3",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172424",
            "telephone_number": "412-708-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-617-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRUKKOVALUR",
        "first_name": "NIKHIL VAISHNAV",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "999999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwaine Dale Tipton, MSW, LCSW
• Sara Jane Tipton, PA-C
• Brian Anthony Tirado, MD
• Tanatuch Tiratrakoonseree, MD
• Kiranmaye Tiriveedhi, M.D.
• Chelsea Marie Tisckos, AU.D.
• Laura R Tishey, PSY.D.
• Greg Tissi, PLPC
• Jeffrey B Titus, PH.D.
• Brandon Tivis, D.D.S.

• Student in an Organized Health Care Education/Training Program in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Student in an Organized Health Care Education/Training Program in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.