Individual provider Active NPI

Arun Thukkani, MD

  • Interventional Cardiology Physician
  • Lewiston, ME
National Provider Identifier
1467573659
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2022-01010 Issued in NC
Practice address
60 High St
Lewiston, ME 04240-7616
Phone
(207) 753-3900
Fax
(207) 753-3902
NPI assigned
Apr 3, 2007
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 2008021953 MO
Interventional Cardiology Physician 207RI0011X MD21380 ME
Hospitalist Physician 208M00000X 200802953 MO
Interventional Cardiology Physician 207RI0011X 2022-01010 NC Primary

Addresses

Primary practice location

60 High St
Lewiston, ME 04240-7616

Mailing address

300 E Wendover Ave
Greensboro, NC 27401-1229
Phone (366) 635-2203

Other practice location 1

1126 N Church St Ste 300
Greensboro, NC 27401-1037
Phone (336) 938-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220809003871 NC Practitioner - Interventional Cardiology 9335387745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1126 N Church St
Suite 300
Greensboro, NC 27401-1037
Phone (336) 938-0800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008021953MOMDInterventional Cardiology Physician
2022-01010NCMDInterventional Cardiology Physician
200802953MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Jul 30, 2023 Accepting new patients
Central Maine Medical Center Past Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205

3200 Northline Ave
Ste 250
Greensboro, NC 27408
Phone (336) 273-7900

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

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 1

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1467573659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011229",
            "telephone_number": "366-635-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407616",
            "telephone_number": "207-753-3900",
            "fax_number": "207-753-3902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1126 N Church St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011037",
            "country_code": "US",
            "telephone_number": "336-938-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THUKKANI",
        "first_name": "ARUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2008021953",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ME",
            "license": "MD21380",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "200802953",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2022-01010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.