Active NPI
Minoo N Kavarana, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Charleston, SC
National Provider Identifier
1992779128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 32973
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-0100 - Phone
- (843) 792-1414
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 37044 | KY | |
| Pediatric Surgery Physician | 2086S0120X | 32973 | SC | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 32973 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-0100
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000377926 | Other | KY | ANTHEM PROVIDER # |
| 61-1427889 | Other | KY | HUMANA |
| 61-1427889 | Other | KY | TRICARE |
| P00333912 | Other | KY | RRMCR |
| 030670000 | Other | KY | BLACK LUNG |
| 50006567 | Other | KY | PASSPORT HEALTH PLAN |
| 64099567 | Medicaid | KY | |
| 61-1427889 | Other | KY | BLUEGRASS FAMILY HEALTH |
| 61-1427889 | Other | KY | CHA |
| 61-1427889 | Other | KY | UHC |
| C40884 | Other | KY | CUMBERLAND HEALTHCARE INC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32973 | SC | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| Medical University Hospital Authority | Past | Accepting new patients |
Locations
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Charleston, SC
- NPI 1043241110
-
- Family Medicine Physician
- Charleston, SC
- NPI 1982678496
-
- General Acute Care Hospital
- Charleston, SC
- NPI 1073605879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279497600000",
"number": "1992779128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461",
"telephone_number": "843-792-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294250100",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAVARANA",
"first_name": "MINOO",
"middle_name": "N",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2010-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "KY",
"license": "37044",
"primary": false
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "SC",
"license": "32973",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "SC",
"license": "32973",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER #",
"identifier": "000000377926",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "61-1427889",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "61-1427889",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMCR",
"identifier": "P00333912",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLACK LUNG",
"identifier": "030670000",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT HEALTH PLAN",
"identifier": "50006567",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64099567",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUEGRASS FAMILY HEALTH",
"identifier": "61-1427889",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA",
"identifier": "61-1427889",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "61-1427889",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CUMBERLAND HEALTHCARE INC",
"identifier": "C40884",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.