NPIMap

Individual provider Active NPI

Samith Thomas Kochuparambil, MD

  • Hematology & Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1548490329
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
55683 Issued in MN
Practice address
910 E 26TH St
Suite 100
Minneapolis, MN 55404-4526
Phone
(612) 884-6300
Fax
(612) 884-6363
NPI assigned
Jul 15, 2009
Last updated
Jun 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 003640 GA
Hematology & Oncology Physician 207RH0003X 55683 MN Primary
Hematology & Oncology Physician 207RH0003X 106191 MN

Addresses

Primary practice location

910 E 26TH St
Suite 100
Minneapolis, MN 55404-4526

Mailing address

910 E 26TH St
Suite 100
Minneapolis, MN 55404-4526
Phone (612) 884-6300

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidWI
ENROLLEDMedicaidMN

Other names 1

  • Dr. Samith Thomas K Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120829000785 MN Practitioner - Medical OncologyPractitioner - Hematology 5597912352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

910 E 26TH St
Suite 100 200
Minneapolis, MN 55404-4526
Phone (612) 884-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.19 of 100Reported as apm
Quality
72.34
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003640GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Minnesota Oncology Hematology, PA Internal Medicine CurrentSince Jul 13, 2015 Accepting new patients
Minnesota Oncology Hematology, PA Internal Medicine Current Accepting new patients
Allina Health System CurrentSince Jul 20, 2015 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince Jul 13, 2015 Accepting new patients
Allina Health System CurrentSince Jul 20, 2015 Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients
Minnesota Oncology Hematology, PA Internal Medicine Past Accepting new patients

Locations

1175 Paysphere Cir
Chicago, IL 60674

675 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

110105 Pioneer Trl W
Ste 302
Chaska, MN 55318
Phone (952) 361-5800

10150 Niagara Ln N
#100
Maple Grove, MN 55369
Phone (763) 220-1316

11850 Blackfoot St NW
Ste 100
Minneapolis, MN 55433
Phone (763) 712-2100

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

6545 France Ave S
Ste 210
Minneapolis, MN 55435
Phone (952) 928-2900

910 E 26th St
Ste 100200
Minneapolis, MN 55404
Phone (612) 884-6300

2805 Campus Dr
Ste 105
Plymouth, MN 55441
Phone (763) 519-7440

1580 Beam Ave
Saint Paul, MN 55109
Phone (651) 255-8480

2550 University Ave W
Ste 105N
Saint Paul, MN 55114
Phone (651) 602-5335

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

560 S Maple St
Ste 100
Waconia, MN 55387
Phone (952) 442-6006

6025 Lake Rd
Ste 110
Woodbury, MN 55125
Phone (651) 735-7414

Interoperability endpoints

  • Direct secure messaging: samith.kochuparambil@moh.ikm.direct-ci.com

Organizations & group practices 8

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 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1548490329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E 26TH ST",
            "address_2": "SUITE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044526",
            "telephone_number": "612-884-6300",
            "fax_number": "612-884-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E 26TH ST",
            "address_2": "SUITE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044526",
            "telephone_number": "612-884-6300",
            "fax_number": "612-884-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHUPARAMBIL",
        "first_name": "SAMITH THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "003640",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "55683",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "106191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMITH THOMAS",
            "last_name": "K",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.