Individual provider Active NPI

Mohan Karisankappa Puttaswamy, MBBS

  • Pediatric Orthopaedic Surgery Physician
  • Quincy, MA
National Provider Identifier
1306116686
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
31386 Issued in ZZ
Practice address
95 W Squantum St
111, Archstone Quincy
Quincy, MA 02171-2123
Phone
(716) 598-5664
NPI assigned
Jan 4, 2012
Last updated
Mar 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X 31386 ZZ Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 31386 ZZ

Addresses

Primary practice location

95 W Squantum St
111, Archstone Quincy
Quincy, MA 02171-2123

Mailing address

95 W Squantum St
111, Archstone Quincy
Quincy, MA 02171-2123
Phone (716) 598-5664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31386ZZMDPediatric Orthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1306116686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 W SQUANTUM ST",
            "address_2": "111, ARCHSTONE QUINCY",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712123",
            "telephone_number": "716-598-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 W SQUANTUM ST",
            "address_2": "111, ARCHSTONE QUINCY",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712123",
            "telephone_number": "716-598-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARISANKAPPA PUTTASWAMY",
        "first_name": "MOHAN",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "ZZ",
            "license": "31386",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "ZZ",
            "license": "31386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.