Active NPI
Karthikeyan Chinnakkannu, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 304050
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (718) 992-7669
- NPI assigned
- Mar 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Foot and Ankle Surgery Physician | 207XX0004X | R-10963 | IA | |
| Orthopaedic Trauma Physician | 207XX0801X | 304050 | NY | |
| Orthopaedic Trauma Physician | 207XX0801X | P101696 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 304050 | NY | Primary |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
199 Mount Eden Pkwy FL 4
Bronx, NY 10457-7703
Phone (718) 992-7669
Other practice location 1
1201 11th Ave S
Birmingham, AL 35205
Phone (800) 822-8816
Other practice location 2
200 Hawkins Dr Dept Of
Iowa City, IA 52242-1009
Phone (319) 356-7160
Other practice location 3
800 Spruce St
1 Cathcart
Philadelphia, PA 19107-6130
Phone (215) 662-3340
Other practice location 4
7901 Broadway
Elmhurst, NY 11373-1329
Phone (215) 470-5010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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
- Orthopedic Surgery
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 992-7669
Hospital & facility affiliations
- Bronxcare Hospital Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304050 | NY | MD | Registered Nurse |
| P101696 | NY | MD | Orthopaedic Trauma Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronxcare Health System | Current | Accepting new patients | |
| Bronxcare Health System | Current | Accepting new patients | |
| Kanwarpaul S. Grewal Medical PLLC | Foot and Ankle Surgery | Current | Accepting new patients |
| Bronxcare Health System | Past | Accepting new patients |
Locations
1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104
30 Merrick Ave
Ste 103
East Meadow, NY 11554
Phone (516) 743-9450
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1245390855
-
- Orthopaedic Surgery of the Spine Physician
- East Meadow, NY
- NPI 1780244798
Foot and Ankle Surgery
-
- Methadone Clinic
- Bronx, NY
- NPI 1801428222
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1417027558
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1417027558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1508307737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 MOUNT EDEN PKWY FL 4",
"city": "BRONX",
"state": "NY",
"postal_code": "104577703",
"telephone_number": "718-992-7669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "718-992-7669"
}
],
"practiceLocations": [
{
"address_1": "1201 11th Ave S",
"address_purpose": "LOCATION",
"city": "Birmingham",
"state": "AL",
"postal_code": "35205",
"country_code": "US",
"telephone_number": "800-822-8816",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Hawkins Dr Dept Of",
"address_purpose": "LOCATION",
"city": "Iowa City",
"state": "IA",
"postal_code": "522421009",
"country_code": "US",
"telephone_number": "319-356-7160",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "800 Spruce St",
"address_2": "1 Cathcart",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191076130",
"country_code": "US",
"telephone_number": "215-662-3340",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7901 Broadway",
"address_purpose": "LOCATION",
"city": "Elmhurst",
"state": "NY",
"postal_code": "113731329",
"country_code": "US",
"telephone_number": "215-470-5010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHINNAKKANNU",
"first_name": "KARTHIKEYAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0004X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
"state": "IA",
"license": "R-10963",
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": "NY",
"license": "304050",
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": "NY",
"license": "P101696",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "NY",
"license": "304050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.