NPIMap

Individual provider Active NPI

Avin Pothuloori, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • North Kansas City, MO
National Provider Identifier
1245523141
Registry record updated May 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2016030319 Issued in MO
Practice address
2790 Clay Edwards Dr Ste 1250
C/O Hellman & Rosen Endocrine
North Kansas City, MO 64116-3260
Phone
(816) 421-3700
Fax
(816) 421-1654
NPI assigned
May 25, 2011
Last updated
May 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2016030319 MO Primary

Addresses

Primary practice location

2790 Clay Edwards Dr Ste 1250
C/O Hellman & Rosen Endocrine
North Kansas City, MO 64116-3260

Mailing address

2790 Clay Edwards Dr Ste 1250
C/O Hellman & Rosen Endocrine
North Kansas City, MO 64116-3260
Phone (816) 421-3700

Other identifiers 1

IdentifierTypeStateIssuer
P01775520OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20210816001716 NE Practitioner - Endocrinology 0345471249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

7710 Mercy Rd
Suite 2000
Omaha, NE 68124-2323
Phone (402) 717-0820

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016030319MOMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Alegent Creighton Clinic CurrentSince Aug 1, 2023 Accepting new patients
Alegent Creighton Clinic Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7710 Mercy Rd
Ste 2000
Omaha, NE 68124
Phone (402) 717-0820

Interoperability endpoints

  • Direct secure messaging: avin.pothuloori@direct.nmhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1245523141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 1250",
            "address_2": "C/O HELLMAN & ROSEN ENDOCRINE",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163260",
            "telephone_number": "816-421-3700",
            "fax_number": "816-421-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 1250",
            "address_2": "C/O HELLMAN & ROSEN ENDOCRINE",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163260",
            "telephone_number": "816-421-3700",
            "fax_number": "816-421-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHULOORI",
        "first_name": "AVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2016030319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01775520",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.