Individual provider Active NPI

Malar Kuppan, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1295216190
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP11701 Issued in AZ
Practice address
5310 W Thunderbird Rd Ste 202
Glendale, AZ 85306-4712
Phone
(623) 301-9992
Fax
(623) 432-7006
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP11701 AZ
Adult Health Nurse Practitioner 363LA2200X AP11701 AZ
Gerontology Nurse Practitioner 363LG0600X AP11701 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP11701 AZ Primary

Addresses

Primary practice location

5310 W Thunderbird Rd Ste 202
Glendale, AZ 85306-4712

Mailing address

5519 W Banff LN
Glendale, AZ 85306-3045
Phone (623) 261-5258

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210002790 AZ Practitioner - Nurse Practitioner 1456695998 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5310 W Thunderbird Rd
Suite 202
Glendale, AZ 85306-4712
Phone (623) 301-9992

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rd Psyche PLLC Acute Care Current Accepting new patients
Desert View Counseling and Consulting, Inc. Psychiatric/Mental Health CurrentSince Dec 18, 2020 Accepting new patients
Rd Medical PLLC Acute Care CurrentSince Apr 20, 2025 Accepting new patients
Rd Integrated Health PLLC Acute Care CurrentSince Jun 1, 2022 Accepting new patients
Wings of Hope Medical Services, LLC CurrentSince May 6, 2019 Accepting new patients
RSH LLC Past Accepting new patients

Locations

5310 W Thunderbird Rd
Ste 202
Glendale, AZ 85306
Phone (602) 547-3300

13260 N 94th Dr
Ste 100
Peoria, AZ 85381
Phone (623) 487-7763

11022 N 28th Dr
Ste 270
Phoenix, AZ 85029
Phone (602) 971-0304

19820 N 7th St
Ste 140
Phoenix, AZ 85024
Phone (623) 487-7763

14810 N Del Webb Blvd
Sun City, AZ 85351
Phone (480) 550-9096

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1295216190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5519 W BANFF LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063045",
            "telephone_number": "623-261-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 202",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064712",
            "telephone_number": "623-301-9992",
            "fax_number": "623-432-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPAN",
        "first_name": "MALAR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP11701",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP11701",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP11701",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP11701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.