Desert Interventional Spine Consultants

Primary specialty

SpecialistTaxonomy code 174400000X

License

34866 Issued in AZ

Legal business name

DESERT INTERVENTIONAL SPINE CONSULTANTS

Practice address

1410 W Guadalupe Rd Ste 125
Gilbert, AZ 85233-3041

Phone

(480) 838-1914

Fax

(480) 838-9434

NPI assigned

Jan 4, 2010

Last updated

Oct 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ajay N Yeddu, MDNPI 1871553529

Title

President

Phone

(480) 361-7680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FGIDBA

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ajay Neilchand Yeddu I, MD

  • Interventional Pain Medicine Physician
  • Gilbert, AZ
  • NPI 1871553529
  Medicare reassignment Care Compare group NPD Authorized official
• Kristen Marie Tenney

  • Family Nurse Practitioner
  • Chandler, AZ
  • NPI 1093211880
  Medicare reassignment Care Compare group NPD
• Emily Elizabeth Tyler, NP

  • Pain Medicine Physician
  • Phoenix, AZ
  • NPI 1548632623

  Multi-Specialty

  Medicare reassignment NPD
• Marissa Sinsabaugh, NP

  • Nurse Practitioner
  • Gilbert, AZ
  • NPI 1376210179
  NPD

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1154651750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "HIGLEY",
            "state": "AZ",
            "postal_code": "852360097",
            "telephone_number": "480-838-1914",
            "fax_number": "480-838-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W GUADALUPE RD STE 125",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333041",
            "telephone_number": "480-838-1914",
            "fax_number": "480-838-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT INTERVENTIONAL SPINE CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "YEDDU",
        "authorized_official_first_name": "AJAY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-361-7680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "34866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Dermatology & Skin Cancer Specialists, P.C.
• Desert Dolphin Aquatic Therapy & Rehab
• Desert Eyesthetics PC
• Desert Heart Hospice LLC
• Desert Horizon Medical Group
• Desert Medical Group
• Desert Prosthetic & Orthotic Rehabilitation
• Desert Pulmonary & Sleep Consultants PLC
• Desert Sage Healing, LLC
• Desert Sage Integrative Care & Consulting, LLC

• Specialist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.