Vellore Kirubakaran, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

04-19582 Issued in KS

Practice address

4121 W 83Rd St
Suite 254
Prairie Village, KS 66208-5300

Phone

(913) 649-5567

Fax

(913) 649-7563

NPI assigned

Mar 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Vellore Kirubakaran M D P a

  • Psychiatry Physician
  • Prairie Village, KS
  • NPI 1669689188
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1619009172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27127",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662257127",
            "telephone_number": "913-649-5567",
            "fax_number": "913-649-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 W 83RD ST",
            "address_2": "SUITE 254",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085300",
            "telephone_number": "913-649-5567",
            "fax_number": "913-649-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRUBAKARAN",
        "first_name": "VELLORE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04-19582",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "35824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD KANSAS CITY",
            "identifier": "11476056",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202129227",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260036797",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "11476046",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100115600D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD KANSAS",
            "identifier": "632223",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecile Khoury, M.D.
• Lauren Kilber, LPC
• Sarah Marie Kindscher, M.ED./ED.S.
• Laportia King, LPC
• Nicholas Ryan Kirmer, DDS
• Zachary Matthew Kissel, PHARM. D.
• Julie Kittinger, RN
• Sarah C Kleinschmidt, PA
• Jennifer Klindworth
• Sara Nicole Koenemann, FNP-BC

• Psychiatry Physician in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.