Individual provider Active NPI

Daniel Sundaresan Paul, MD

  • Pulmonary Disease Physician
  • Rogers, AR
National Provider Identifier
1841266319
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E11756 Issued in AR
Practice address
2708 S Rife Medical LN Ste 200
Rogers, AR 72758
Phone
(479) 338-3080
Fax
(479) 338-3089
NPI assigned
Feb 24, 2006
Last updated
May 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 134572 MO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 134572 MO
Pulmonary Disease Physician 207RP1001X 134572 MO
Pulmonary Disease Physician 207RP1001X E11756 AR Primary

Addresses

Primary practice location

2708 S Rife Medical LN Ste 200
Rogers, AR 72758

Mailing address

2708 S Rife Medical LN Ste 200
Rogers, AR 72758-1456
Phone (479) 338-3080

Other practice location 1

2708 S Rife Medical Ln Ste 200
Rogers, AR 72758
Phone (479) 338-3080

Other practice location 2

902 Wollard Blvd
Richmond, MO 64085-2229
Phone (816) 776-2201

Other identifiers 2

IdentifierTypeStateIssuer
205149503MedicaidMO
27053019OtherMOBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20190522001557 AR Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7214998384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
134572MOMDInternal Medicine Physician
E11756ARMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jun 3, 2019 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jun 3, 2019 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste 200
Rogers, AR 72758
Phone (479) 338-3080

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Interoperability endpoints

  • Direct secure messaging: dpaul1027214@directc.mercy.net

Organizations & group practices 3

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 4

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1841266319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE 200",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581456",
            "telephone_number": "479-338-3080",
            "fax_number": "479-338-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE 200",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-338-3080",
            "fax_number": "479-338-3089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2708 S Rife Medical Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "72758",
            "country_code": "US",
            "telephone_number": "479-338-3080",
            "fax_number": "479-338-3089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 Wollard Blvd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "MO",
            "postal_code": "640852229",
            "country_code": "US",
            "telephone_number": "816-776-2201",
            "fax_number": "816-480-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUL",
        "first_name": "DANIEL",
        "middle_name": "SUNDARESAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "134572",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "134572",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "134572",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E11756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205149503",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27053019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.