NPIMap

Individual provider Active NPI

Jayakrishna Paineni

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1275952525
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54010 Issued in AZ
Practice address
59 S Hibbert
Mesa, AZ 85210-1414
Phone
(480) 344-6200
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 54010 AZ Primary

Addresses

Primary practice location

59 S Hibbert
Mesa, AZ 85210-1414

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NC2 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
I20170809003237 AZ Practitioner - Family Practice 3476832247 Reassigns benefits to 1 organization
I20240916000504 NC Practitioner - Family PracticePractitioner - Internal Medicine 3476832247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

332 N Trade St
Matthews, NC 28105-1728
Phone (704) 512-6820

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54010AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2025 Accepting new patients
District Medical Group, Inc CurrentSince Jul 19, 2017 Accepting new patients
District Medical Group, Inc CurrentSince Jul 19, 2017 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients

Locations

2601 E Roosevelt St
Fl 1
Phoenix, AZ 85008

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

15110 John J Delaney Dr
Charlotte, NC 28277
Phone (704) 302-8100

13640 Steelecroft Pkwy
Ste 320
Charlotte, NC 28278
Phone (704) 302-8900

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

332 N Trade St
#2000
Matthews, NC 28105
Phone (704) 302-8500

332 N Trade St
Matthews, NC 28105
Phone (704) 302-8500

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

Interoperability endpoints

  • Direct secure messaging: jpaineni131823@direct.valleywisehealth.org
  • Direct secure messaging: jpaineni2946217@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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 7

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275952525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 S HIBBERT",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852101414",
            "telephone_number": "480-344-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINENI",
        "first_name": "JAYAKRISHNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "54010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.