NPIMap

Individual provider Active NPI

Aravind Rao Kokkirala, M.D

  • Cardiovascular Disease Physician
  • Providence, RI
National Provider Identifier
1235116864
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD16358 Issued in RI
Practice address
164 Summit Ave
Providence, RI 02906-2853
Phone
(860) 545-1559
NPI assigned
Dec 24, 2005
Last updated
Nov 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 043983 CT
Cardiovascular Disease Physician 207RC0000X MD16358 RI Primary

Addresses

Primary practice location

164 Summit Ave
Providence, RI 02906-2853

Mailing address

PO Box 40,000 Dept 634
Hartford Hospital Professional Services
Hartford, CT 06151-0634
Phone (860) 545-7602

Other identifiers 1

IdentifierTypeStateIssuer
001439835MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181203002742 RI Practitioner - Cardiovascular Disease (Cardiology) 4183645112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4102

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237593NYMDLicensed Practical Nurse
MD16358RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jan 2, 2019 Accepting new patients
The Miriam Hospital CurrentSince Jan 2, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 2, 2019 Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Jan 2, 2019 Accepting new patients
Firo Inc Past Accepting new patients

Locations

950 Warren Ave
Fl 2
East Providence, RI 02914

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

Organizations & group practices 7

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 5

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": "1135382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1235116864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40,000 DEPT 634",
            "address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061510634",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "860-545-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKKIRALA",
        "first_name": "ARAVIND RAO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-24",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "043983",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD16358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001439835",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.