NPIMap

Individual provider Active NPI

Mohan Krishna Bangaru

  • Nephrology Physician
  • Sun City, AZ
National Provider Identifier
1275932121
Registry record updated Nov 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
75184 Issued in AZ
Practice address
10615 W Thunderbird Blvd Ste C100
Sun City, AZ 85351-3097
Phone
(623) 974-1763
Fax
(623) 972-2038
NPI assigned
Aug 16, 2014
Last updated
Nov 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 75184 AZ Primary

Addresses

Primary practice location

10615 W Thunderbird Blvd Ste C100
Sun City, AZ 85351-3097

Mailing address

3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396
Phone (602) 759-6883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230821000278 GA Practitioner - NephrologyPractitioner - Internal Medicine 6709107527 Reassigns benefits to 1 organization
I20250312002264 AZ Practitioner - NephrologyPractitioner - Internal Medicine 6709107527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Kidney Institute PLCGroup PAC ID 8224930987, 100 clinicians

Practice addresses (Care Compare)

2149 E Warner Rd
Suite 101
Tempe, AZ 85284-3495
Phone (480) 610-6100

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC Single Specialty CurrentSince Sep 12, 2025 Accepting new patients
Atlanta Kidney Specialists LLC Single Specialty CurrentSince Aug 1, 2023 Accepting new patients
Banner Cancer Center Specialists LLC Single Specialty CurrentSince Sep 12, 2025 Accepting new patients
Southwest Kidney Institute, PLC Single Specialty CurrentSince Mar 1, 2025 Accepting new patients
Southwest Kidney Institute, PLC Single Specialty CurrentSince Mar 1, 2025 Accepting new patients

Locations

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

301 S Power Rd
Mesa, AZ 85206

9305 W Thomas Rd
Ste 255
Phoenix, AZ 85037
Phone (623) 247-9235

2149 E Warner Rd
Tempe, AZ 85284

2149 E Warner Rd
Ste 101
Tempe, AZ 85284
Phone (480) 610-6111

2149 E Warner Rd
Ste 102
Tempe, AZ 85284
Phone (623) 247-0808

130 Medical Way
Ste D
Stockbridge, GA 30281
Phone (470) 419-4000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHHGAD
  • Direct secure messaging: mohan.krishna.bangaru.1@2697.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1408147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1275932121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182396",
            "telephone_number": "602-759-6883",
            "fax_number": "602-224-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 W THUNDERBIRD BLVD STE C100",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513097",
            "telephone_number": "623-974-1763",
            "fax_number": "623-972-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGARU",
        "first_name": "MOHAN KRISHNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-16",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "75184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.