Active NPI
Tanawat Jirakulaporn, M.D.
- Internal Medicine Physician
- Minneapolis, MN
National Provider Identifier
1841494945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MDR-4590
- Practice address
- 516 Delaware St SE
14-142 PWB
Minneapolis, MN 55455-0356 - Phone
- (612) 624-0123
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MDR-4590 | HI | Primary |
Addresses
Primary practice location
516 Delaware St SE
14-142 PWB
Minneapolis, MN 55455-0356
Mailing address
2285 Stewart Ave Apt 1411
Saint Paul, MN 55116-3155
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR-4590 | HI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841494945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2285 STEWART AVE APT 1411",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551163155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE ST SE",
"address_2": "14-142 PWB",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550356",
"telephone_number": "612-624-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIRAKULAPORN",
"first_name": "TANAWAT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "MDR-4590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.