Individual provider Active NPI

Thomman M Kuruvilla, DPM

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
National Provider Identifier
1578628095
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006123-1 Issued in NY
Practice address
7195 Advanced Way
Las Vegas, NV 89113-3691
Phone
(702) 740-5327
Fax
(702) 740-5328
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N006123-1 NY Primary

Addresses

Primary practice location

7195 Advanced Way
Las Vegas, NV 89113-3691

Mailing address

PO Box 50605
Henderson, NV 89016-0605
Phone (702) 740-5327

Other identifiers 1

IdentifierTypeStateIssuer
0606OtherNVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070906000511 NV Practitioner - Podiatry 9234233818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7195 Advanced Way
Las Vegas, NV 89113-3691
Phone (702) 740-5327

Merit-based Incentive Payment System (MIPS)

Final score
70.69 of 100Reported as group
Quality
42.71
Promoting interoperability
100
Improvement activities
40
Cost
59.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0606NVMDMarriage & Family Therapist
N006123-1NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ada I Vera DPM LTD PastSince Jun 12, 2022 Accepting new patients
Yee Advanced Orthopedics & Sports Medicine PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tkuruvilla@aosmlv.directmessaging.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1578628095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50605",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890160605",
            "telephone_number": "702-740-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7195 ADVANCED WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133691",
            "telephone_number": "702-740-5327",
            "fax_number": "702-740-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUVILLA",
        "first_name": "THOMMAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006123-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0606",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.