Active NPI
Amol Vinayak Purandare, M.D.
- Pediatrics Physician
- Kansas City, MO
National Provider Identifier
1508123852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2018016657
- Practice address
- 2401 Gillham Rd
Kansas City, MO 64108-4619 - Phone
- (816) 234-3000
- Fax
- (816) 302-9939
- NPI assigned
- Apr 11, 2012
- Last updated
- Jan 13, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD043173 | DC | |
| Pediatrics Physician | 208000000X | 2018016657 | MO | Primary |
Addresses
Primary practice location
2401 Gillham Rd
Kansas City, MO 64108-4619
Mailing address
2401 Gillham Rd
Provider Enrollment
Kansas City, MO 64108-4619
Phone (816) 701-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Florida State University College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4202 E Fowler Ave
Tampa, FL 33620-6750
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD043173 | DC | MD | Pediatrics Physician |
| 2018016657 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients |
Locations
12901 Bruce B Downs Blvd
#62
Tampa, FL 33612
4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331
Networks
- Freedom Health HMO Network
Interoperability endpoints
- apurandare210865@direct.tgh.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 4
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.
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- General Practice Physician
- Tampa, FL
- NPI 1326088295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642032000000",
"number": "1508123852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"address_2": "PROVIDER ENROLLMENT",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-701-5200",
"fax_number": "816-302-9939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-234-3000",
"fax_number": "816-302-9939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURANDARE",
"first_name": "AMOL",
"middle_name": "VINAYAK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-11",
"last_updated": "2022-01-13",
"certification_date": "2022-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DC",
"license": "MD043173",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2018016657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.