Praveena R Kothur, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

30666 Issued in AZ

Practice address

6003 W Thunderbird Rd Ste 1
Glendale, AZ 85306-4004

Phone

(602) 805-3129

Fax

(888) 355-6609

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Praveena R Kothur Professional name

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

Specialty

Allergy/Immunology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Allergy and Asthma Clinic PLLCGroup PAC ID 8123004660, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Valley Allergy and Asthma Clinic PLLC

  • Specialist
  • Glendale, AZ
  • NPI 1760429641

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1114973179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5148",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853125148",
            "telephone_number": "602-805-3129",
            "fax_number": "888-355-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 W THUNDERBIRD RD STE 1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064004",
            "telephone_number": "602-805-3129",
            "fax_number": "888-355-6609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14418 W Meeker Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853755290",
            "country_code": "US",
            "telephone_number": "602-805-3129",
            "fax_number": "888-355-6609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTHUR",
        "first_name": "PRAVEENA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "30666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "792053",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRAVEENA",
            "last_name": "KOTHUR",
            "middle_name": "R",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Susan Koscak
• Sierra Koskovich, RBT
• Michael Angelo Kostarides, PHARMD
• Karly Koster, FNP-C
• Matthew S Koster, PT, DPT
• Zarine M Kotian, M.D.
• Alison Marie Kotowski, MOT, OTR/L
• Leslie A Kotsis, NP-ADULT
• Roshan Kottoor
• Alan Kovin, LASAC

• Allergy & Immunology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Allergy & Immunology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.