Indira Doris Konanur, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

243668 Issued in MA

Practice address

28 State St
Suite 2850
Boston, MA 02109-1775

Phone

(617) 903-5009

Fax

(617) 903-5009

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• One Medical Group, PC

  • Family Medicine Physician
  • Boston, MA
  • NPI 1467701821

  Internal Medicine

  NPD (past)
• Pratt Surgical Associates Inc

  • Surgery Physician
  • Boston, MA
  • NPI 1912944182
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1891993994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941047001",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 STATE ST",
            "address_2": "SUITE 2850",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091775",
            "telephone_number": "617-903-5009",
            "fax_number": "617-903-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONANUR",
        "first_name": "INDIRA",
        "middle_name": "DORIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "14926",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "243668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30228286",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akane Kominami, LICSW
• Kathryn Grace Almon Kompa, MD
• Andrew J. Kompel, M.D.
• Sierra Cheyanne Komry, PHARMD
• Stephen Komyati, DMD
• Olivia Konaxis, PA-C
• Sri Meghana Konda, MD
• Jordan Kondo
• Svetlana Kondratiev, MD
• Rayees Ahmed Konduru, MD

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.