Karthik Kavasseri, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2017-0166 Issued in NM

Practice address

Route 301 North
Zuni, NM 87327

Phone

(505) 782-4431

Fax

(505) 782-4502

NPI assigned

Jun 30, 2014

Last updated

Oct 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, NM, AK3 enrollments

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 3

Specialty

Family Practice

Education

Michigan State University College of Human Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Merit-based Incentive Payment System (MIPS)

Final score

82.36 of 100Reported as group

Quality

87.45

Improvement activities

0

Cost

93.44

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkavasseri4027437@ak.providencedirect.org

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.

• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  Medicare reassignment Care Compare group NPD
• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• Fedko Emergency Physicians New Mexico LLC

  • Emergency Medicine Physician
  • Grants, NM
  • NPI 1770047441
  Medicare reassignment NPD
• Zuni Indian Hospital

  • General Acute Care Hospital
  • Zuni, NM
  • NPI 1497843734

  TX

  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment NPD
• DHHS, PHS, Naihs, Gallup Indian Medical Center

  dba Tohatchi Health Center

  • Federal Public Health Clinic/Center
  • Tohatchi, NM
  • NPI 1902875594
  NPD
• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1245645183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 467",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "873270467",
            "telephone_number": "505-782-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 301 NORTH",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "87327",
            "telephone_number": "505-782-4431",
            "fax_number": "505-782-4502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 E Nizhoni Blvd",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015748",
            "country_code": "US",
            "telephone_number": "517-303-1239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVASSERI",
        "first_name": "KARTHIK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2017-0166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1320751",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Horeis, PHYSICAL THERAPIST
• Michael Jaffe, RPH
• Andrew Jensen
• Paula Lynn Johns, O.D.
• Judith Lynn Kalley
• David Kessler, MD
• Jason Kurland, M.D.
• Poonam Mahajan
• Lynette Martinez, LADAC
• Mark Martinez, LADAC

• Family Medicine Physician in Zuni, NM
• Providers in Zuni, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.