Individual provider Active NPI

Dinesh P Koirala, M.D.

  • Anesthesiology Physician
  • Bay City, MI
National Provider Identifier
1184657611
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301039279 Issued in MI
Practice address
1900 Columbus Ave
Bay City, MI 48708-6880
Phone
(989) 894-3077
Fax
(989) 894-6138
NPI assigned
Jul 8, 2006
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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 4301039279 MI Primary

Addresses

Primary practice location

1900 Columbus Ave
Bay City, MI 48708-6880

Mailing address

PO Box 660857
Dallas, TX 75266-0857
Phone (855) 709-4498

Other identifiers 1

IdentifierTypeStateIssuer
1184657611MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100820000914 MI Practitioner - Anesthesiology 2860526167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services Associates PCGroup PAC ID 4385557602, 67 clinicians

Practice addresses (Care Compare)

2775 Blake Rd
Jackson, MI 49201-8838
Phone (517) 787-2906

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301039279MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Associates, PC Anesthesiology CurrentSince Dec 1, 2016 Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1184657611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660857",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660857",
            "telephone_number": "855-709-4498",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086880",
            "telephone_number": "989-894-3077",
            "fax_number": "989-894-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIRALA",
        "first_name": "DINESH",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301039279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184657611",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.