Individual provider Active NPI

Priyanka M Nimbalkar, MD

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1740540954
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53319 Issued in TN
Practice address
2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333
Phone
(865) 909-0090
Fax
(865) 909-9883
NPI assigned
May 22, 2012
Last updated
Jun 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53319 TN Primary

Addresses

Primary practice location

2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333

Mailing address

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

Other names 1

  • Priyanka Gaikwad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20151103002373 TN Practitioner - Internal Medicine 2567784648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2604

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2675

7725 W Reno Ave
Suite 150
Oklahoma City, OK 73127-9712

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53319TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Summit Medical Group, PLLC CurrentSince Sep 1, 2015 Accepting new patients
Statcare Inpatient LLC Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Internal Medicine Past Accepting new patients

Locations

2240 Sutherland Ave
Ste 104
Knoxville, TN 37919
Phone (865) 909-0090

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1740540954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SUTHERLAND AVE",
            "address_2": "SUITE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192333",
            "telephone_number": "865-909-0090",
            "fax_number": "865-909-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMBALKAR",
        "first_name": "PRIYANKA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "53319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRIYANKA",
            "last_name": "GAIKWAD",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.