Individual provider Active NPI

Vilasini Vidnya Rekhala, MD

  • Pediatrics Physician
  • Peona, AZ
National Provider Identifier
1306266192
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
54764 Issued in AZ
Practice address
9059 W. Lake Pleasant Pkwy
Ste E-540
Peona, AZ 85382
Phone
(623) 322-3380
Fax
(623) 322-4399
NPI assigned
Apr 21, 2014
Last updated
May 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 54764 AZ Primary

Addresses

Primary practice location

9059 W. Lake Pleasant Pkwy
Ste E-540
Peona, AZ 85382

Mailing address

9059 W. Lake Pleasant Pkwy
Ste E-540
Peona, AZ 85382
Phone (623) 322-3380

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250523002009 AZ Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3476858622

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54764AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Estrella Medical Center Past Accepting new patients
VHS of Arrowhead, Inc Past Accepting new patients
Pleasant Pediatrics PLC Pediatrics PastSince Apr 1, 2021 Accepting new patients
Pleasant Pediatrics PLC Pediatrics Past Accepting new patients
Pleasant Pediatrics Pediatrics PastSince Dec 6, 2022 Accepting new patients
Pleasant Pediatrics PLC Pediatrics Past Accepting new patients
Pleasant Pediatrics PLC Pediatrics Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1306266192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9059 W. LAKE PLEASANT PKWY",
            "address_2": "STE E-540",
            "city": "PEONA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "623-322-3380",
            "fax_number": "623-322-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9059 W. LAKE PLEASANT PKWY",
            "address_2": "STE E-540",
            "city": "PEONA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "623-322-3380",
            "fax_number": "623-322-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REKHALA",
        "first_name": "VILASINI",
        "middle_name": "VIDNYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "54764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peona, AZ

Sources for this page

Verify at the official NPI Registry.