Active NPI
Kishan T Kishan, M.D.
- Surgery Physician
- Warsaw, IN
National Provider Identifier
1356391569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- IN01036480A
- Practice address
- 2219 Dubois Dr
Warsaw, IN 46580-3212 - Phone
- (574) 269-3420
- Fax
- (574) 269-2234
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | IN01036480A | IN | Primary |
Addresses
Primary practice location
2219 Dubois Dr
Warsaw, IN 46580-3212
Mailing address
2219 Dubois Dr
Warsaw, IN 46580-3212
Phone (574) 269-3420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100088150 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IN01036480A | IN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warsaw Medical Group | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1356391569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2219 DUBOIS DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803212",
"telephone_number": "574-269-3420",
"fax_number": "574-269-2234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2219 DUBOIS DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803212",
"telephone_number": "574-269-3420",
"fax_number": "574-269-2234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISHAN",
"first_name": "KISHAN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "IN01036480A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100088150",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.