Individual provider Active NPI

D Dean Kumpuris, MD

  • Gastroenterology Physician
  • Little Rock, AR
National Provider Identifier
1932197118
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
N5637 Issued in AR
Practice address
415 N University Ave
Little Rock, AR 72205-3108
Phone
(501) 666-0249
Fax
(501) 666-4340
NPI assigned
Oct 11, 2005
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X N5637 AR Primary

Addresses

Primary practice location

415 N University Ave
Little Rock, AR 72205-3108

Mailing address

415 N University Ave
Little Rock, AR 72205-3108
Phone (501) 666-0249

Other identifiers 1

IdentifierTypeStateIssuer
104790001MedicaidAR

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
I20051118000170 AR Practitioner - Gastroenterology 6406808724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Emory University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

415 N University Ave
Little Rock, AR 72205-3108
Phone (501) 666-0249

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy125
Upper gastrointestinal (GI) endoscopy for acid reflux50

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N5637ARMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
D.Dean Kumpuris,M.D.and Glenn R.Davis,M.D.,P.a. Gastroenterology CurrentSince Mar 1, 1982 Accepting new patients
St. Vincent Medical Group Gastroenterology CurrentSince Sep 26, 2005 Accepting new patients
Endoscopy Center of Arkansas, LLC PastSince Jul 6, 2004 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

415 N University Ave
Little Rock, AR 72205
Phone (501) 664-6841

417 N University Ave
Little Rock, AR 72205
Phone (501) 664-0249

Interoperability endpoints

  • Direct secure messaging: ddean.kumpuris@svmgs.eclinicaldirectplus.com
  • Direct secure messaging: dkumpuris468747@direct.stlukeshealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1932197118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-666-0249",
            "fax_number": "501-666-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-666-0249",
            "fax_number": "501-666-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMPURIS",
        "first_name": "D",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "N5637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104790001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.