Provider Demographics
NPI:1386694586
Name:KANSUPADA, KASHYAP BHARAT (MD)
Entity type:Individual
Prefix:DR
First Name:KASHYAP
Middle Name:BHARAT
Last Name:KANSUPADA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:
Practice Address - Street 1:400 PARK ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3368
Practice Address - Country:US
Practice Address - Phone:704-295-3700
Practice Address - Fax:704-295-3707
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600585207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC376555OtherMAMSI
SC772572OtherWELLCARE
NC8947737Medicaid
NC8836828002OtherCIGNA
180033451OtherRAILROAD MEDICARE
NC20474OtherBCBS MEDPOINT
NC141025OtherCOVENTRY
NC15346OtherPARTNERS
NC19600OtherWELLPATH
SC000000292730OtherUNISON HEALTH PLAN OF SC
SC20087603OtherSELECT HEALTH OF SC
NC5624177OtherAETNA
NC11496OtherDOCTORS HEALTH PLAN
NC25146OtherKANAWHA
NC47737OtherBCBS
NC65084OtherMEDCOST
NC0841231OtherUNITED HEALTHCARE
SCN00586Medicaid
SC000000292730OtherUNISON HEALTH PLAN OF SC
NC0841231OtherUNITED HEALTHCARE
NC11496OtherDOCTORS HEALTH PLAN
180033451OtherRAILROAD MEDICARE