Individual provider Active NPI

Steve Jose Kuruvilla, MD

  • Psychiatry Physician
  • Valrico, FL
National Provider Identifier
1386892404
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
169746 Issued in FL
Practice address
2884 Yellow Barn LN
Valrico, FL 33594-6879
Phone
(631) 525-8078
Fax
(631) 444-6031
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 169746 FL Primary
Psychiatry Physician 2084P0800X 329844-01 NY

Addresses

Primary practice location

2884 Yellow Barn LN
Valrico, FL 33594-6879

Mailing address

2884 Yellow Barn LN
Valrico, FL 33594-6879
Phone (631) 525-8078

Other practice location 1

Stony Brook University Hospital
Medical Staff Office T14
Stony Brook, NY 11794-7148
Phone (631) 444-2754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260601000740 NY Practitioner - Psychiatry 6406376730

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Creighton University School of Medicine, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Corporate Blvd S
Suite 100
Yonkers, NY 10701

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
169746FLMDPsychiatry Physician
329844-01NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1386892404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2884 YELLOW BARN LN",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335946879",
            "telephone_number": "631-525-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2884 YELLOW BARN LN",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335946879",
            "telephone_number": "631-525-8078",
            "fax_number": "631-444-6031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook University Hospital",
            "address_2": "Medical Staff Office T14",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117947148",
            "country_code": "US",
            "telephone_number": "631-444-2754",
            "fax_number": "631-444-6031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURUVILLA",
        "first_name": "STEVE",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "169746",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "329844-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.