Individual provider Active NPI

Niveditha Thangaraj

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1164809471
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD471342 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-7237
Fax
(215) 707-9389
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD471342 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-7237

Other practice location 1

132 South 10th St
10th Floor Main
Philadelphia, PA 19107-5244
Phone (215) 955-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200921001125 PA Practitioner - Diagnostic Radiology 7416375670 Reassigns benefits to 1 organization
I20211023000141 AZ Practitioner - Diagnostic Radiology 7416375670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Diagnostic Imaging LLCGroup PAC ID 7416946199, 121 clinicians
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians

Practice addresses (Care Compare)

9220 E Mountain View Rd
Suite 100
Scottsdale, AZ 85258-5134
Phone (480) 425-5000

9700 N 91St St
Suite B 100
Scottsdale, AZ 85258-5054
Phone (832) 915-2534

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Jul 15, 2020 Accepting new patients
Southwest Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Sep 1, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Jul 15, 2020 Accepting new patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Sep 1, 2021 Accepting new patients

Locations (25 of 29)

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

10230 W Happy Valley Pkwy
Ste 100
Peoria, AZ 85383
Phone (623) 266-4699

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

1515 E Bethany Home Rd
Phoenix, AZ 85014
Phone (602) 812-3080

2323 W Rose Garden Ln
Phoenix, AZ 85027
Phone (623) 931-7999

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

16641 N 40th St
Ste 1
Phoenix, AZ 85032
Phone (623) 931-7999

9700 N 91st St
Ste B100
Scottsdale, AZ 85258

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

3501 N Scottsdale Rd
Ste 130
Scottsdale, AZ 85251

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255
Phone (480) 324-7000

9220 E Mountain View Rd
Ste 100
Scottsdale, AZ 85258

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

5316 E Shea Blvd
Ste 150
Scottsdale, AZ 85254
Phone (480) 534-4530

16575 W Waddell Rd
Surprise, AZ 85388
Phone (623) 300-9110

1625 N Campbell Ave
Tucson, AZ 85719

2365 Heritage Center Dr
Furlong, PA 18925
Phone (215) 728-3883

Organizations & group practices 5

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 5

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1164809471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 South 10th St",
            "address_2": "10th Floor Main",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075244",
            "country_code": "US",
            "telephone_number": "215-955-6000",
            "fax_number": "215-923-1562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THANGARAJ",
        "first_name": "NIVEDITHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD471342",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.