Trinath Kuruvella, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036153537 Issued in IL

Practice address

1625 S State St
Belvidere, IL 61008-5907

Phone

(610) 984-5640

NPI assigned

Apr 8, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

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.

• Swedishamerican Hospital

  dba SwedishAmerican Medical Group

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1962451732
  Medicare reassignment Care Compare group NPD
• Swedishamerican Hospital

  • Community/Retail Pharmacy
  • Rockford, IL
  • NPI 1306635982
  NPD
• Swedishamerican Hospital

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Rockford, IL
  • NPI 1356759294
  NPD
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)
• Prairie Schooner Emergency Physicians, a Medical Corporation

  • Emergency Medicine Physician
  • Porterville, CA
  • NPI 1205035581

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1841619863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 S STATE ST",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610085907",
            "telephone_number": "610-984-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Dallas Dr",
            "address_2": "Apt 1223",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762055278",
            "country_code": "US",
            "telephone_number": "610-984-5640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4864 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712026400",
            "country_code": "US",
            "telephone_number": "318-330-7615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 Burnett Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605027046",
            "country_code": "US",
            "telephone_number": "610-984-5640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURUVELLA",
        "first_name": "TRINATH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036153537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkuruvellamd1140376@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1625 S State St",
            "city": "Belvidere",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610085907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carrie Kooyenga, PTA
• Kathryn Korth, LSW, CADC
• Alan J Kossman, D.D.S.
• David Bradley Kozlov, M.D.
• Norbert J Kulpinski, OD
• Linda Kyle-Rimkus, LCSW
• L Robert Warren MD LLC
• Laboratory Corporation of America
• Dylen Adair Larsen, ABOC
• Laurie Maringer, LCSW Inc

• Family Medicine Physician in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.