Individual provider Active NPI

Pokala R Kiran, MD

  • Colon & Rectal Surgery Physician
  • New York, NY
National Provider Identifier
1871798330
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
269812-1 Issued in NY
Practice address
161 Fort Washington Ave FL 8
New York, NY 10032-3729
Phone
(212) 342-1161
Fax
(212) 305-0267
NPI assigned
Jun 15, 2007
Last updated
Apr 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 269812-1 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave FL 8
New York, NY 10032-3729

Mailing address

161 Fort Washington Ave FL 8
New York, NY 10032-3729
Phone (212) 342-1155

Other identifiers 2

IdentifierTypeStateIssuer
3590801MedicaidNY
2751820MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130812000808 NY Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 9133228281 Reassigns benefits to 3 organizations
I20170811002912 NJ Practitioner - Colorectal Surgery (Proctology) 9133228281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

161 Fort Washington Ave
New York, NY 10032-3729
Phone (212) 305-8559

177 Fort Washington Ave
New York, NY 10032-3733
Phone (212) 305-7060

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy125
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269812-1NYMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 19, 2017 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 19, 2017 Accepting new patients
The Trustees of Columbia University in the City of New York Colon & Rectal Surgery CurrentSince Jun 1, 2013 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

400 Kelby St
Ste 11
Fort Lee, NJ 07024

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
Fl 8
New York, NY 10032
Phone (212) 342-1155

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: rpk9001@direct.nyp.org

Organizations & group practices 9

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 6

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1871798330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-342-1155",
            "fax_number": "212-305-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-342-1161",
            "fax_number": "212-305-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRAN",
        "first_name": "POKALA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "269812-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3590801",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2751820",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.