Individual provider Active NPI

Kalpesh Tarun Vakharia, MD

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1205957396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
229014 Issued in MA
Practice address
11 Park Dr
Apt 12
Boston, MA 02215-4404
Phone
(909) 964-6700
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 229014 MA Primary

Addresses

Primary practice location

11 Park Dr
Apt 12
Boston, MA 02215-4404

Mailing address

11 Park Dr
Apt 12
Boston, MA 02215-4404
Phone (909) 964-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20121003000600 MD Practitioner - Otolaryngology 8123299922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16 S Eutaw St
Suite 400
Baltimore, MD 21201-1699
Phone (410) 328-6866

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229014MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Univ of Maryland Otorhinolaryngology Head & Neck Surgery PA CurrentSince Sep 1, 2012 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Sep 1, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

16 S Eutaw St
Ste 400
Baltimore, MD 21201
Phone (410) 328-1791

5890 Waterloo Rd
Columbia, MD 21045
Phone (410) 328-2603

Interoperability endpoints

  • Direct secure messaging: kvakharia54134@direct.umm.edu

Organizations & group practices 3

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 2

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205957396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PARK DR",
            "address_2": "APT 12",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154404",
            "telephone_number": "909-964-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PARK DR",
            "address_2": "APT 12",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154404",
            "telephone_number": "909-964-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKHARIA",
        "first_name": "KALPESH",
        "middle_name": "TARUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "229014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.