Individual provider Active NPI

Narendra Kutnikar, MD

  • Internal Medicine Physician
  • Monroe, LA
National Provider Identifier
1497742175
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10610R Issued in LA
Practice address
1805 Lamy LN
Monroe, LA 71201-3739
Phone
(318) 388-5383
Fax
(318) 388-5779
NPI assigned
Sep 29, 2005
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 10610R LA Primary

Addresses

Primary practice location

1805 Lamy LN
Monroe, LA 71201-3739

Mailing address

1805 Lamy LN
Monroe, LA 71201-3739
Phone (318) 388-5383

Other identifiers 1

IdentifierTypeStateIssuer
1992470MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20040804000642 LA Practitioner - Internal Medicine 0648241554 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10610RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Billing SFN Single Specialty PastSince Nov 1, 2005 Accepting new patients
St Francis Specialty Hospital,Inc Single Specialty Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1497742175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 LAMY LN",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013739",
            "telephone_number": "318-388-5383",
            "fax_number": "318-388-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 LAMY LN",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013739",
            "telephone_number": "318-388-5383",
            "fax_number": "318-388-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTNIKAR",
        "first_name": "NARENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "10610R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992470",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.