Individual provider Active NPI

Supreet Kaur, M.D.

  • Vascular Neurology Physician
  • Phoenix, AZ
National Provider Identifier
1942640065
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
55333 Issued in AZ
Practice address
2910 N 3Rd Ave # 470
Phoenix, AZ 85013-4434
Phone
(602) 406-6262
Fax
(602) 406-6261
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN19097 FL
Neurology Physician 2084N0400X ME132536 FL
Neurology Physician 2084N0400X 55333 AZ
Vascular Neurology Physician 2084V0102X 55333 AZ Primary

Addresses

Primary practice location

2910 N 3Rd Ave # 470
Phoenix, AZ 85013-4434

Mailing address

2910 N 3Rd Ave # 470
Phoenix, AZ 85013-4434
Phone (602) 406-6262

Other practice location 1

1600 SW Archer Rd
Room 4102
Gainesville, FL 32610-3003
Phone (352) 265-0239

Other practice location 2

240 W Thomas Rd Ste 400
Phoenix, AZ 85013
Phone (602) 406-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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
I20180613001676 AZ Practitioner - Neurology 2961631759 Reassigns benefits to 1 organization
I20200127000310 TX Practitioner - Neurology 2961631759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1004 W 32ND St
200 Ascension Texas Spine and Scoliosis
Austin, TX 78705-1006
Phone (512) 324-3580

1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000

1400 N Ih 35
Austin, TX 78701-1926

1400 N Ih 35 LL
Cl400 Tri County Prac Assoc
Austin, TX 78701-1926
Phone (512) 324-7300

1500 Red River St
Austin, TX 78701-1918
Phone (512) 324-7000

1600 W 38TH St
200 Tri County Practice Association
Austin, TX 78731-6405
Phone (512) 324-3580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME132536FLMDNeurology Physician
55333AZMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Nov 26, 2019 Accepting new patients
St. Joseph'S Outpatient Surgery Center, LLC Current Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
St Josephs Pathology Current Accepting new patients
Winslow Memorial Hospital Inc Current Accepting new patients
Sjhmc Physician Services CurrentSince Apr 27, 2018 Accepting new patients
Dignity Health Past Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

2910 N 3rd Ave
#470
Phoenix, AZ 85013
Phone (602) 406-6262

2910 N 3rd Ave
Ste 430
Phoenix, AZ 85013
Phone (602) 406-7421

240 W Thomas Rd
Ste 301
Phoenix, AZ 85013
Phone (602) 406-6262

2910 N 3rd Ave
Ste 470
Phoenix, AZ 85013
Phone (602) 406-6262

240 W Thomas Rd
Ste 400
Phoenix, AZ 85013
Phone (602) 406-6262

File 56765
Los Angeles, CA 90074

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 and National Provider Directory roles.

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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1942640065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 N 3RD AVE # 470",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134434",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 N 3RD AVE # 470",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134434",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_2": "Room 4102",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-0239",
            "fax_number": "352-265-1107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 W Thomas Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85013",
            "country_code": "US",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "SUPREET",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN19097",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME132536",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "55333",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "AZ",
            "license": "55333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.