Organization Active NPI

Narendra P Myneni MD PC

  • Vascular Surgery Physician
  • Mesa, AZ
National Provider Identifier
1083701239
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
NARENDRA P MYNENI MD PC
Practice address
1450 S Dobson Rd
Suite A302
Mesa, AZ 85202-4712
Phone
(480) 985-1093
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Dr. Narendra P Myneni, MD
Title
Owner/President
Phone
(480) 985-1093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1450 S Dobson Rd
Suite A302
Mesa, AZ 85202-4712

Mailing address

PO Box 6970
Mesa, AZ 85216-6970
Phone (480) 985-1093

Other identifiers 1

IdentifierTypeStateIssuer
AZ0032580OtherAZBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1083701239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6970",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852166970",
            "telephone_number": "480-985-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD",
            "address_2": "SUITE A302",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024712",
            "telephone_number": "480-985-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NARENDRA P MYNENI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "MYNENI",
        "authorized_official_first_name": "NARENDRA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "480-985-1093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0032580",
            "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 Oct 10, 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.

Verify at the official NPI Registry.