Individual provider Active NPI

Kumar Gaurav Prasad, MD

  • Otolaryngology Physician
  • Kansas City, MO
National Provider Identifier
1487882353
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2015009389 Issued in MO
Practice address
9411 N Oak Trfy
Suite 202
Kansas City, MO 64155-2233
Phone
(816) 468-8820
Fax
(816) 468-8898
NPI assigned
Jun 30, 2009
Last updated
Jun 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2015009389 MO Primary
Otolaryngology Physician 207Y00000X 01073660A IN

Addresses

Primary practice location

9411 N Oak Trfy
Suite 202
Kansas City, MO 64155-2233

Mailing address

2700 Clay Edwards Dr
Suite 240
North Kansas City, MO 64116-3251
Phone (816) 691-5287

Other identifiers 1

IdentifierTypeStateIssuer
201232130MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140519001173 IN Practitioner - Otolaryngology 6800019936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Saint Louis University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates PCGroup PAC ID 3375504301, 36 clinicians

Practice addresses (Care Compare)

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604
Phone (260) 426-8117

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.15 of 100Reported as individual
Quality
74.82
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Associates, PC Otolaryngology CurrentSince Sep 1, 2019 Accepting new patients
Meritas Health Corporation Past Accepting new patients
The Hearing Center LLC Past Accepting new patients

Locations

424 Williams St
Angola, IN 46703
Phone (260) 665-2926

1169 N Main St
Ste 5
Bluffton, IN 46714
Phone (260) 827-4368

10021 DuPont Circle Ct
Fort Wayne, IN 46825
Phone (219) 426-8117

5411 Meijer Dr
Fort Wayne, IN 46835
Phone (260) 469-6919

7926 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 459-6924

2003 Stults Rd
Ste 220
Huntington, IN 46750
Phone (260) 463-2133

2814 Theater Ave
Huntington, IN 46750
Phone (260) 356-3611

737 N Detroit St
Warsaw, IN 46580
Phone (260) 436-0259

442 W High St
Bryan, OH 43506
Phone (260) 266-8210

140 Fox Rd
Van Wert, OH 45891
Phone (419) 238-7700

Interoperability endpoints

  • Direct secure messaging: gprasad@entfortwayne.gwaydirect.com

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 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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1487882353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR",
            "address_2": "SUITE 240",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163251",
            "telephone_number": "816-691-5287",
            "fax_number": "816-346-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY",
            "address_2": "SUITE 202",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552233",
            "telephone_number": "816-468-8820",
            "fax_number": "816-468-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "KUMAR",
        "middle_name": "GAURAV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2015009389",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01073660A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201232130",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.