Prabin Thakuri, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

AA46 Issued in FL

Practice address

410 S 11TH St
Lake Wales, FL 33853-4203

Phone

(863) 676-1433

NPI assigned

Oct 14, 2009

Last updated

Oct 14, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Ams National LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1316330830
  Medicare reassignment Care Compare group NPD
• North Tampa Anesthesia Consultants

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1144216433
  Medicare reassignment NPD

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

• Adventhealth Polk South Inc

  dba AdventHealth Lake Wales

  • General Acute Care Hospital
  • Lake Wales, FL
  • NPI 1053972760
  Care Compare affiliation

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1548595259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8739 NW 38TH ST APT 228",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333511502",
            "telephone_number": "612-270-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-676-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKURI",
        "first_name": "PRABIN",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA46",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AA46",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunrise Pediatrics LLC
• Jacqueline Collier Swale, DPT
• Tiffany Christine Tary, OTR/L
• Veronica Taylor, PTA
• Stacy Testa, PA-C
• The Tower Ridge Group LLC
• Emily Morgan Thomas, MS, CCC-SLP
• Felicia Thomas
• Jasmine Monique Thomas, OT
• Panchami Thomas, APRN

• Anesthesiologist Assistant in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Anesthesiologist Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.