Individual provider Active NPI

Kishore Mattappilly Lakshman, MD,MPH

  • Endocrinology, Diabetes & Metabolism Physician
  • Fall River, MA
National Provider Identifier
1992909568
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
232520 Issued in MA
Practice address
289 Pleasant St
Suite 604
Fall River, MA 02721-3005
Phone
(508) 646-7710
Fax
(508) 646-7714
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 232520 MA Primary

Addresses

Primary practice location

289 Pleasant St
Suite 604
Fall River, MA 02721-3005

Mailing address

289 Pleasant St
Suite 604
Fall River, MA 02721-3005
Phone (508) 646-7710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20100730000168 MA Practitioner - EndocrinologyPractitioner - Internal Medicine 4688707466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prima Care, PCGroup PAC ID 2567356017, 222 clinicians

Practice addresses (Care Compare)

277 Pleasant St
Fall River, MA 02721-3005

289 Pleasant St
Fall River, MA 02721-3005

67 Slade'S Ferry Boulevard
Somerset, MA 02726-1220
Phone (508) 676-3292

Hospital & facility affiliations

  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232520MAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Care, PC CurrentSince Jul 1, 2010 Accepting new patients
Prima Care, PC CurrentSince Jul 1, 2010 Accepting new patients

Locations

277 Pleasant St
Fl 4
Fall River, MA 02721
Phone 50867632921244

289 Pleasant St
Ste 604
Fall River, MA 02721
Phone (508) 646-7710

277 Pleasant St
Ste 202
Fall River, MA 02721
Phone (508) 235-0481

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

Interoperability endpoints

  • Direct secure messaging: kishore.lakshman@prima.eclinicaldirectplus.com

Organizations & group practices 2

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 1

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1992909568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 PLEASANT ST",
            "address_2": "SUITE 604",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213005",
            "telephone_number": "508-646-7710",
            "fax_number": "508-646-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 PLEASANT ST",
            "address_2": "SUITE 604",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213005",
            "telephone_number": "508-646-7710",
            "fax_number": "508-646-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKSHMAN",
        "first_name": "KISHORE",
        "middle_name": "MATTAPPILLY",
        "name_prefix": "Dr.",
        "credential": "MD,MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "232520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.