Organization Active NPI

Veracian Healthcare PLC

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1063647733
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33186 Issued in AZ
Legal business name
VERACIAN HEALTHCARE PLC
Practice address
1301 S Crismon Rd
Mesa, AZ 85209-3767
Phone
(480) 275-4998
Fax
(480) 275-4998
NPI assigned
May 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Authorized official

Name
Sai Lakshmi V Chandran, MDNPI 1437123593
Title
Director
Phone
(480) 275-4998

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 33186 AZ Primary

Addresses

Primary practice location

1301 S Crismon Rd
Mesa, AZ 85209-3767

Mailing address

2999 E Linda LN
Gilbert, AZ 85234-6371
Phone (480) 275-4998

Other identifiers 1

IdentifierTypeStateIssuer
431366MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090727000652 AZ Part B Supplier - Clinic/Group Practice 2769535582 Receives reassigned benefits from 2 practitioners
Practice locations: Gilbert, AZ; Chandler, AZ; Mesa, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1063647733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 E LINDA LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852346371",
            "telephone_number": "480-275-4998",
            "fax_number": "480-275-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767",
            "telephone_number": "480-275-4998",
            "fax_number": "480-275-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERACIAN HEALTHCARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-23",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "CHANDRAN",
        "authorized_official_first_name": "SAI LAKSHMI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-275-4998",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431366",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.