Individual provider Active NPI

Salil V. Pradhan, MD

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1013960558
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31823 Issued in AZ
Practice address
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone
(602) 344-5404
Fax
(602) 344-5859
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31823 AZ Primary

Addresses

Primary practice location

2525 E Roosevelt St
Phoenix, AZ 85008-4948

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other identifiers 1

IdentifierTypeStateIssuer
797417MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040223000865 AZ Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1759277254 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31823AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
District Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc Pediatrics Past Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Fl 3
Phoenix, AZ 85008

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2525 E Roosevelt St
Fl 2
Phoenix, AZ 85008

Interoperability endpoints

  • Direct secure messaging: spradhan5251@direct.valleywisehealth.org

Organizations & group practices 4

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1013960558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-5404",
            "fax_number": "602-344-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADHAN",
        "first_name": "SALIL",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "31823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "797417",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.