Jaya H Maddur, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

14396 Issued in AZ

Practice address

111 El Camino Real
Sierra Vista, AZ 85635-2807

Phone

(520) 459-3850

Fax

(520) 459-3857

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Swan Gastroenterology, P.C.

  • Gastroenterology Physician
  • Tucson, AZ
  • NPI 1619368891
  Medicare reassignment NPD

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316038136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EL CAMINO REAL",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352807",
            "telephone_number": "520-459-3850",
            "fax_number": "520-459-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EL CAMINO REAL",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352807",
            "telephone_number": "520-459-3850",
            "fax_number": "520-459-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDUR",
        "first_name": "JAYA",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "14396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lunow
• Luxottica Retail North America Inc
• M.G. Ramirez, D.D.S., P.C.
• M&F Healthcare Services LLC
• Roxanna Macharigue
• Maria L Malek, MS. CCC-SLP
• Theresa Lanika Malone
• Lorraine Catherine Mangan, CCC-SLP
• James Mar, DO
• Marc a Kaplan PLLC

• Gastroenterology Physician in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.