Individual provider Active NPI

Luna Viva Ananda, MD

  • Psychiatry Physician
  • Tempe, AZ
National Provider Identifier
1043415839
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
31841 Issued in AZ
Practice address
1642 S Priest Dr Ste 101
Tempe, AZ 85281-6204
Phone
(480) 929-5100
Fax
(480) 731-1066
NPI assigned
Jun 20, 2007
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 31841 AZ Primary

Addresses

Primary practice location

1642 S Priest Dr Ste 101
Tempe, AZ 85281-6204

Mailing address

3003 N Central Ave
Suite 200
Phoenix, AZ 85012-2902
Phone (602) 685-6000

Other identifiers 1

IdentifierTypeStateIssuer
260516MedicaidAZ

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
I20071030000568 AZ Practitioner - Psychiatry 1153418611 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agave Solutions PLLCGroup PAC ID 0941625651, 12 clinicians
Aurora Behavioral Healthcare - Tempe, LLCGroup PAC ID 3072643337, 7 clinicians

Practice addresses (Care Compare)

10550 W McDowell Rd
Avondale, AZ 85392-4864
Phone (480) 565-3035

6350 S Maple Ave
Tempe, AZ 85283-2857
Phone (480) 345-5400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Behavioral Healthcare - Tempe, LLC Psychiatry CurrentSince Mar 26, 2018 Accepting new patients
Physician Group of Arizona Inc CurrentSince Mar 11, 2013 Accepting new patients
Physician Group of Arizona Inc CurrentSince Mar 11, 2013 Accepting new patients
Agave Solutions PLLC Psychiatry CurrentSince Feb 1, 2026 Accepting new patients
St Lukes Behavioral Hospital LP Past Accepting new patients

Locations

10550 W McDowell Rd
Avondale, AZ 85392
Phone (480) 565-3035

20118 N 67th Ave
Ste 300609
Glendale, AZ 85308
Phone (602) 857-8182

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

6350 S Maple Ave
Tempe, AZ 85283
Phone (480) 345-5400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1043415839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122902",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 S PRIEST DR STE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852816204",
            "telephone_number": "480-929-5100",
            "fax_number": "480-731-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANDA",
        "first_name": "LUNA",
        "middle_name": "VIVA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "31841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260516",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.