Active NPI
Varughese Kuruvilla, M.D.
- Surgery Physician
- Randallstown, MD
National Provider Identifier
1760443816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D23628
- Practice address
- 5400 Old Court Rd
Suite 208
Randallstown, MD 21133-5100 - Phone
- (410) 561-0737
- NPI assigned
- Mar 29, 2006
- Last updated
- Nov 29, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | D23628 | MD | Primary |
Addresses
Primary practice location
5400 Old Court Rd
Suite 208
Randallstown, MD 21133-5100
Mailing address
5401 Old Court Rd
Attn: Credentialing
Randallstown, MD 21133-5103
Phone (410) 601-5524
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20039228 | Other | MD | R/R MEDICARE PROVIDER # |
| CN6601 | Other | MD | R/R MEDICARE GROUP # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D23628 | MD | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sinai Hospital of Baltimore Inc | Past | Accepting new patients | |
| Northwest Hospital Center, Inc | Past | Accepting new patients | |
| Northwest Hospital Center, Inc | Surgery | Past | Accepting new patients |
| Northwest Hospital Center, Inc | Past | Accepting new patients | |
| Northwest Hospital Center, Inc. | Past | Accepting new patients | |
| Northwest Hospital Center, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/136fea15-c667-40bc-9ed2-b1115d62123b/
- vkuruvilla230222@direct.umm.edu
Organizations & group practices 6
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.
-
dba Northwest Cardiology
- Cardiovascular Disease Physician
- Randallstown, MD
- NPI 1437255734
-
dba Northwest Wound Clinic
- Surgery Physician
- Randallstown, MD
- NPI 1447354790
-
dba Northwest Hand Clinic
- Surgery of the Hand (Surgery) Physician
- Randallstown, MD
- NPI 1982708228
-
dba Northwest Medical Associates
- Pulmonary Disease Physician
- Randallstown, MD
- NPI 1740290980
-
- Internal Medicine Physician
- Baltimore, MD
- NPI 1255359782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1760443816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 OLD COURT RD",
"address_2": "ATTN: CREDENTIALING",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211335103",
"telephone_number": "410-601-5524",
"fax_number": "410-601-8946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 OLD COURT RD",
"address_2": "SUITE 208",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211335100",
"telephone_number": "410-561-0737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KURUVILLA",
"first_name": "VARUGHESE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-29",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MD",
"license": "D23628",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R/R MEDICARE PROVIDER #",
"identifier": "20039228",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R/R MEDICARE GROUP #",
"identifier": "CN6601",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Randallstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.