Nishani Kuruppu, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

01763 Issued in MD

Practice address

12070 Old Line Ctr Ste 110
Waldorf, MD 20602-2503

Phone

(301) 843-9581

NPI assigned

May 7, 2020

Sex

Female

Sole proprietor

Yes

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 DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Maryland Foot and Ankle LLCGroup PAC ID 9830198928, 4 clinicians

Foot and Ankle Specialists of the Mid-Atlantic LLCGroup PAC ID 6305017633, 157 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkuruppu1060337@direct.umm.edu

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.

• Southern Maryland Foot and Ankle LLC

  dba Southern Maryland Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • Waldorf, MD
  • NPI 1285809715

  DC

  Medicare reassignment Care Compare group NPD
• Foot and Ankle Specialists of the Mid-Atlantic, LLC

  • Podiatrist
  • Raleigh, NC
  • NPI 1073804712

  Foot & Ankle Surgery, MD

  Medicare reassignment Care Compare group NPD
• Foot and Ankle Specialists of the Mid-Atlantic, LLC

  • Podiatrist
  • Concord, NC
  • NPI 1255213997

  Foot & Ankle Surgery

  NPD

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1225650781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR STE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022503",
            "telephone_number": "301-843-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR STE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022503",
            "telephone_number": "301-843-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12070 Old Line Ctr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206022503",
            "country_code": "US",
            "telephone_number": "301-843-9581",
            "fax_number": "301-843-0921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURUPPU",
        "first_name": "NISHANI",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishan M Mathur MD (Cambridge Oncology and Infusion Center)
• Amanda Jayne Kromer, N.P
• Melissa Kubick, OD
• Gowri Kularatna, M.D.
• Alexis Kurtianyk, OT
• Jane Kutsushi, NP
• Athanasia Kyriazis
• Labil/ Labyem LLC.
• Laboratory Corporation of America Holdings
• Versenia Ladson

• Foot & Ankle Surgery Podiatrist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Foot & Ankle Surgery Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.