NPIMap

Individual provider Active NPI

Sharmila Parvathaneni, MD

  • Nephrology Physician
  • Kingman, AZ
National Provider Identifier
1225334840
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
49359 Issued in AZ
Practice address
2901 N Stockton Hill Rd Ste B
Kingman, AZ 86401
Phone
(928) 718-0777
Fax
(928) 718-0877
NPI assigned
Jan 28, 2011
Last updated
Jul 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036126682 IL
Nephrology Physician 207RN0300X 49359 AZ Primary

Addresses

Primary practice location

2901 N Stockton Hill Rd Ste B
Kingman, AZ 86401

Mailing address

PO Box 3837
Kingman, AZ 86402-3837
Phone (928) 718-0777

Other identifiers 1

IdentifierTypeStateIssuer
1225334840MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140610002471 AZ Practitioner - NephrologyPractitioner - Internal Medicine 6204050370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Kidney Care LLCGroup PAC ID 2466703970, 4 clinicians

Practice addresses (Care Compare)

2901 N Stockton Hill Rd
Suite B
Kingman, AZ 86401-4121
Phone (928) 718-0777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.15 of 100Reported as group
Quality
51.08
Improvement activities
40
Cost
89.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036126682ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Kidney Care LLC Nephrology CurrentSince Sep 1, 2018 Accepting new patients

Locations

2901 N Stockton Hill Rd
Ste B
Kingman, AZ 86401
Phone (928) 718-0777

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kingman Regional Medical CenterKingman, AZ, CCN 030055 Hospital Corporate Director Jul 1, 2022
Kingman Regional Medical Center Home HealthKingman, AZ, CCN 037050 Home health agency Corporate Director Jul 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1225334840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3837",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864023837",
            "telephone_number": "928-718-0777",
            "fax_number": "928-718-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86401",
            "telephone_number": "928-718-0777",
            "fax_number": "928-718-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARVATHANENI",
        "first_name": "SHARMILA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-28",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036126682",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "49359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225334840",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.