Individual provider Active NPI

Niteen S Andalkar, MD

  • Neurological Surgery Physician
  • Mesa, AZ
National Provider Identifier
1124057070
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
35878 Issued in AZ
Practice address
2045 S Vineyard
Ste. 142
Mesa, AZ 85210-6889
Phone
(480) 330-6010
Fax
(480) 507-0019
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 35878 AZ Primary

Addresses

Primary practice location

2045 S Vineyard
Ste. 142
Mesa, AZ 85210-6889

Mailing address

2045 S Vineyard
Ste. 142
Mesa, AZ 85210-6889
Phone (480) 330-6010

Other identifiers 2

IdentifierTypeStateIssuer
35878OtherAZSTATE LICENSE
115379MedicaidAZ

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
I20060919000159 AZ Practitioner - Neurosurgery 8820007453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Rochester School of Medicine and Dentistry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2045 S Vineyard
Suite 144
Mesa, AZ 85210-6891
Phone (480) 330-6010

Hospital & facility affiliations

  • Abrazo West Campus Hospital, Goodyear, AZ, CCN 030110
  • Abrazo Scottsdale Campus Hospital, Phoenix, AZ, CCN 030083

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion97
Laminectomy or laminotomy (partial removal of spine bones)34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35878AZMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Neurosurgery, LLC Neurological Surgery CurrentSince Jan 1, 2009 Accepting new patients
Arizona Spine and Joint Hospital LLC Current Accepting new patients

Locations

2045 S Vineyard
Ste 144
Mesa, AZ 85210
Phone (480) 330-6010

2045 S Vineyard
Ste 142
Mesa, AZ 85210
Phone (480) 330-6010

Interoperability endpoints

  • Direct secure messaging: niteenandalkar@asjh.medalliesdirect.net

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1124057070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 S VINEYARD",
            "address_2": "STE. 142",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106889",
            "telephone_number": "480-330-6010",
            "fax_number": "480-507-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 S VINEYARD",
            "address_2": "STE. 142",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106889",
            "telephone_number": "480-330-6010",
            "fax_number": "480-507-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDALKAR",
        "first_name": "NITEEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "35878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "35878",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115379",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.