NPIMap

Individual provider Active NPI

Thirumal Reddy Dubbaka, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1487881892
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
E-6767 Issued in AR
Practice address
2 Saint Vincent Cir FL 3
Little Rock, AR 72205-5423
Phone
(501) 552-4677
Fax
(501) 552-4555
NPI assigned
Jun 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X E-6767 AR Primary

Addresses

Primary practice location

2 Saint Vincent Cir FL 3
Little Rock, AR 72205-5423

Mailing address

2 Saint Vincent Cir FL 3
Little Rock, AR 72205-5423
Phone (501) 552-4677

Other practice location 1

16221 Saint Vincent Way
Suite 220
Little Rock, AR 72223
Phone (501) 552-5958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110301000883 AR Practitioner - HospitalistPractitioner - Family PracticePractitioner - Geriatric MedicinePractitioner - Emergency Medicine 0749461341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Geriatric Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-6767ARMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Infirmary Medical Center CurrentSince Jul 1, 2013 Accepting new patients
St. Vincent Medical Group CurrentSince Apr 16, 2017 Accepting new patients
Ozarks Neurology Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
St. Vincent Infirmary Medical Center CurrentSince Jul 1, 2013 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

2 Saint Vincent Cir
Fl 3
Little Rock, AR 72205
Phone (501) 524-4677

16221 Saint Vincent Way
Ste 220
Little Rock, AR 72223
Phone (501) 552-5958

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

Interoperability endpoints

  • Direct secure messaging: thirumal.dubbaka@svmgg.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1487881892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR FL 3",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-552-4677",
            "fax_number": "501-552-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR FL 3",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-552-4677",
            "fax_number": "501-552-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16221 Saint Vincent Way",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "72223",
            "country_code": "US",
            "telephone_number": "501-552-5958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBBAKA",
        "first_name": "THIRUMAL",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E-6767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.