Individual provider Active NPI

Suman Misra

  • Nephrology Physician
  • Phoenix, AZ
National Provider Identifier
1023470879
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
59144 Issued in AZ
Practice address
2545 E Thomas Rd Ste 120
Phoenix, AZ 85016-7969
Phone
(602) 419-3378
NPI assigned
Mar 22, 2016
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 59144 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X 59144 AZ Primary
Cardiovascular Disease Physician 207RC0000X 59144 AZ

Addresses

Primary practice location

2545 E Thomas Rd Ste 120
Phoenix, AZ 85016-7969

Mailing address

2545 E Thomas Rd Ste 120
Phoenix, AZ 85016-7969
Phone (602) 419-3378

Other practice location 1

500 W Thomas Rd Ste 900A
Phoenix, AZ 85013-4223
Phone (602) 406-3540

Other practice location 2

5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-1800

Other practice location 3

500 W Thomas Rd Ste 300
Phoenix, AZ 85013-4294
Phone (602) 406-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smisra1214325@ehrdirect.mayoclinicmsg.org

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
I20190918002350 AZ Practitioner - NephrologyPractitioner - Internal Medicine 6709116775 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians
Akdhc LLCGroup PAC ID 8123912136, 125 clinicians
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

2545 E Thomas Rd
Suite 120
Phoenix, AZ 85016-7969
Phone (602) 419-3378

500 W Thomas Rd
680 DHMG St Joseph's Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017

5701 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-4200

5777 E Mayo Blvd
Phoenix, AZ 85054-4502

5779 E Mayo Blvd
Speciality Building
Phoenix, AZ 85054-4502
Phone (480) 301-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59144AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
St Josephs Pathology Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Aug 1, 2023 Accepting new patients
Akdhc Surgery Center, LLC Nephrology Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Aug 1, 2023 Accepting new patients
Mayo Clinic Arizona CurrentSince Jul 1, 2022 Accepting new patients
Mayo Clinic Arizona CurrentSince Jul 1, 2022 Accepting new patients
Banner - University Super Specialists LLC CurrentSince Nov 13, 2023 Accepting new patients
Dignity Health Past Accepting new patients

Locations

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1441 N 12th St
Fl 2AND3
Phoenix, AZ 85006

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

2545 E Thomas Rd
Ste 120
Phoenix, AZ 85016
Phone (602) 419-3378

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

3320 N 2nd St
Phoenix, AZ 85012
Phone (602) 200-8288

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

4620 N 16th St
Ste 200
Phoenix, AZ 85016
Phone (480) 616-2822

500 W Thomas Rd
Ste 300A
Phoenix, AZ 85013

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

13400 E Shea Blvd
Scottsdale, AZ 85259

File 56765
Los Angeles, CA 90074

Interoperability endpoints

  • Direct secure messaging: smisra172999@direct.valleywisehealth.org
  • Direct secure messaging: suman.misra.1@11625.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1023470879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E THOMAS RD STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167969",
            "telephone_number": "602-419-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 E THOMAS RD STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167969",
            "telephone_number": "602-419-3378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Thomas Rd Ste 900A",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134223",
            "country_code": "US",
            "telephone_number": "602-406-3540",
            "fax_number": "602-406-7186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5777 E Mayo Blvd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850544502",
            "country_code": "US",
            "telephone_number": "480-342-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Thomas Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134294",
            "country_code": "US",
            "telephone_number": "602-406-8000",
            "fax_number": "602-406-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISRA",
        "first_name": "SUMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "59144",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "59144",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "59144",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smisra1214325@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.