Individual provider Active NPI

Kaivan Dadachanji

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1285130807
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
011148 Issued in AZ
Practice address
2025 W Northern Ave
Phoenix, AZ 85021-5157
Phone
(833) 855-9973
NPI assigned
Apr 3, 2018
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 011148 AZ Primary
Pediatrics Physician 208000000X 20A17808 CA

Addresses

Primary practice location

2025 W Northern Ave
Phoenix, AZ 85021-5157

Mailing address

8088 W Whitney Dr
Peoria, AZ 85345-6564

Other practice location 1

3500 Fifth Ave Ste 101
San Diego, CA 92103-5020
Phone (619) 295-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, 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
I20210720002133 CA Practitioner - Pediatric Medicine 0042613648 Reassigns benefits to 1 organization
I20240823001994 AZ Practitioner - Pediatric Medicine 0042613648 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17808CAMDPediatrics Physician
17808CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 16, 2021 Accepting new patients
Maricopa County Special Health Care District Current Accepting new patients
Maricopa County Special Health Care District CurrentSince Jul 25, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Aug 5, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
District Medical Group, Inc CurrentSince Aug 5, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Maricopa County Special Health Care District CurrentSince Jul 25, 2024 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients
San Diego Uptown Pediatric Medical Group, Inc Pediatrics PastSince May 7, 2023 Accepting new patients

Locations

2025 W Northern Ave
Phoenix, AZ 85021
Phone (602) 655-6300

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

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

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

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

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

Interoperability endpoints

  • Direct secure messaging: kdadachanji105921@direct.llu.edu
  • Direct secure messaging: kdadachanji272234@direct.valleywisehealth.org

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1285130807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8088 W WHITNEY DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 W NORTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215157",
            "telephone_number": "833-855-9973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Fifth Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921035020",
            "country_code": "US",
            "telephone_number": "619-295-3911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DADACHANJI",
        "first_name": "KAIVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "011148",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A17808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.