Active NPI
Thimmavajjhala Sreecharana, M.D.
- Orthopaedic Hand Surgery Physician
- Peoria, AZ
National Provider Identifier
1013984970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 19302
- Practice address
- 13260 N 94TH Dr
Suite 101
Peoria, AZ 85381-4828 - Phone
- (623) 933-2732
- Fax
- (623) 972-1323
- NPI assigned
- Feb 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 19302 | AZ | Primary |
Addresses
Primary practice location
13260 N 94TH Dr
Suite 101
Peoria, AZ 85381-4828
Mailing address
PO Box 5336
Peoria, AZ 85385-5336
Phone (623) 933-2732
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171182 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19302 | AZ | MD | Orthopaedic Hand Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1013984970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5336",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853855336",
"telephone_number": "623-933-2732",
"fax_number": "623-972-1323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13260 N 94TH DR",
"address_2": "SUITE 101",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814828",
"telephone_number": "623-933-2732",
"fax_number": "623-972-1323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SREECHARANA",
"first_name": "THIMMAVAJJHALA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-28",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "AZ",
"license": "19302",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171182",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.