Individual provider Active NPI

Kavya Puranik, MD

  • Neonatal-Perinatal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1710234349
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
01078070A Issued in IN
Practice address
8111 Township Line Rd
Indianapolis, IN 46260-2479
Phone
(317) 415-7921
NPI assigned
Aug 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01078070A IN
Neonatal-Perinatal Medicine Physician 2080N0001X 01078070A IN Primary

Addresses

Primary practice location

8111 Township Line Rd
Indianapolis, IN 46260-2479

Mailing address

10330 N Meridian St # 300
Indianapolis, IN 46290-1024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170608002043 IN Practitioner - Pediatric Medicine 2961770243 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01078070AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Jul 17, 2017 Accepting new patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Jul 17, 2017 Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8111 Township Line Rd
Indianapolis, IN 46260
Phone (317) 415-7921

Organizations & group practices 2

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": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1710234349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST # 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 TOWNSHIP LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602479",
            "telephone_number": "317-415-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURANIK",
        "first_name": "KAVYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01078070A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01078070A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.