Mrudangi Thakur, M.D

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

210957 Issued in NY

Practice address

3650 Hill Blvd
Jefferson Valley, NY 10535-1500

Phone

(914) 962-8888

Fax

(914) 962-8881

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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 NY

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

Specialty

Plastic and Reconstructive SurgeryAlso: Hand Surgery

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mthakur68080@northwell.direct-ci.com

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.

• Mrudangi Thakur Plastic & Reconstructive Surgery PC

  • Plastic Surgery Physician
  • Jefferson Valley, NY
  • NPI 1588782916
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1649381302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 HILL BLVD",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351500",
            "telephone_number": "914-962-8888",
            "fax_number": "914-962-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 HILL BLVD",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351500",
            "telephone_number": "914-962-8888",
            "fax_number": "914-962-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKUR",
        "first_name": "MRUDANGI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "210957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02267889",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Jefferson Valley, NY
• Providers in Jefferson Valley, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; 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.
• 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.