Active NPI
Meera Kattapuram
- Dermatology Physician
- Omaha, NE
National Provider Identifier
1629771191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 10002
- Practice address
- 4014 Leavenworth St
Omaha, NE 68105-1026 - Phone
- (402) 559-6128
- NPI assigned
- Mar 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 10002 | NE | Primary |
Addresses
Primary practice location
4014 Leavenworth St
Omaha, NE 68105-1026
Mailing address
4014 Leavenworth St
Omaha, NE 68105-1026
Other practice location 1
1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 241-6500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241001004252 | NE | Order and Referring Only - Dermatology | 8628509635 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10002 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1629771191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4014 LEAVENWORTH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4014 LEAVENWORTH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051026",
"telephone_number": "402-559-6128"
}
],
"practiceLocations": [
{
"address_1": "1 Gustave L Levy Pl",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100296504",
"country_code": "US",
"telephone_number": "212-241-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KATTAPURAM",
"first_name": "MEERA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-23",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NE",
"license": "10002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.