Individual provider Active NPI

Venkat Raghav Bhaskara, DO

  • Student in an Organized Health Care Education/Training Program
  • Mesa, AZ
National Provider Identifier
1194514653
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162
Phone
(480) 827-5500
NPI assigned
May 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162

Mailing address

1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162
Phone (480) 827-5500

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
I20250703003762 AZ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2062926892

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1194514653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S COUNTRY CLUB DR STE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105162",
            "telephone_number": "480-827-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S COUNTRY CLUB DR STE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105162",
            "telephone_number": "480-827-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHASKARA",
        "first_name": "VENKAT",
        "middle_name": "RAGHAV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.