NPIMap

Individual provider Active NPI

Supriya Kairamkonda, MD

  • Neurology Physician
  • Henderson, NV
National Provider Identifier
1770038069
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01084571A Issued in IN
Practice address
10001 S Eastern Ave Ste 200
Henderson, NV 89052-3908
Phone
(702) 790-1521
NPI assigned
Aug 17, 2016
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01084571A IN Primary

Addresses

Primary practice location

10001 S Eastern Ave Ste 200
Henderson, NV 89052-3908

Mailing address

10001 S Eastern Ave Ste 200
Henderson, NV 89052-3908
Phone (702) 790-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905001784 NV Practitioner - Neurology 6800213786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ammar PLLCGroup PAC ID 6204107840, 4 clinicians

Practice addresses (Care Compare)

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ammar PLLC Neurology CurrentSince Jun 27, 2023 Accepting new patients

Locations

2863 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 483-4483

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

Organizations & group practices 1

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1770038069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523908",
            "telephone_number": "702-790-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523908",
            "telephone_number": "702-790-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIRAMKONDA",
        "first_name": "SUPRIYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01084571A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.