Individual provider Active NPI

Vivek B Narasimhan, M.D

  • Internal Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1013302884
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
62666 Issued in AZ
Practice address
1840 Mesquite Ave Ofc Pe
Lake Havasu City, AZ 86403-5771
Phone
(928) 208-4598
Fax
(623) 227-2000
NPI assigned
Mar 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18068 NV
Internal Medicine Physician 207R00000X 62666 AZ Primary

Addresses

Primary practice location

1840 Mesquite Ave Ofc Pe
Lake Havasu City, AZ 86403-5771

Mailing address

1840 Mesquite Ave Ofc Pe
Lake Havasu City, AZ 86403-5771
Phone (928) 208-4598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NJ2 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
I20210405000808 AZ Practitioner - Internal Medicine 7618279068 Reassigns benefits to 1 organization
I20241014002873 NJ Practitioner - Internal Medicine 7618279068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newark Community Health Centers IncGroup PAC ID 2163334665, 39 clinicians

Practice addresses (Care Compare)

741 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

751 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

92 -96 Ferry St
Newark, NJ 07104-4309
Phone (973) 803-4510

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Orthopedic Institute, LLC CurrentSince May 1, 2023 Accepting new patients
Lakeside Orthopedic Institute LLC Current Accepting new patients
Newark Community Health Centers, Inc CurrentSince Oct 1, 2024 Accepting new patients
Serve MD LLC CurrentSince Aug 15, 2024 Accepting new patients
Newark Community Health Centers, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Lakeside Orthopedic Institute LLC CurrentSince May 1, 2023 Accepting new patients

Locations

25 Riviera Blvd
Lk Havasu Cty, AZ 86403
Phone (928) 505-7246

7900 E Florentine Rd
Prescott Vly, AZ 86314
Phone (480) 550-9096

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

Networks

  • NM HMO C-SNP

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EECFDD
  • Direct secure messaging: vivek.narasimhan.1@22773.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA/Endpoint/HBFIAA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Care HospiceBullhead City, AZ, CCN 031680 Hospice Contracted Managing Employee Mar 30, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1013302884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE OFC PE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "928-208-4598",
            "fax_number": "623-227-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE OFC PE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "928-208-4598",
            "fax_number": "623-227-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARASIMHAN",
        "first_name": "VIVEK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "18068",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "62666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.