Individual provider Active NPI

Krishna Kishor Kasireddy, MD

  • Hospitalist Physician
  • Sun City West, AZ
National Provider Identifier
1316184948
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
51232 Issued in AZ
Practice address
14502 W Meeker Blvd
Sun City West, AZ 85375-5282
Phone
(623) 524-8814
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 276270 NY
Hospitalist Physician 208M00000X 7811 SD
Hospitalist Physician 208M00000X 51232 AZ Primary

Addresses

Primary practice location

14502 W Meeker Blvd
Sun City West, AZ 85375-5282

Mailing address

14502 W Meeker Blvd
Sun City West, AZ 85375-5282
Phone (623) 524-8814

Other identifiers 1

IdentifierTypeStateIssuer
6006483MedicaidSD

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
I20151019001045 AZ Practitioner - Internal Medicine 0345435707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14502 W Meeker Blvd
Sun City, AZ 85375-5282
Phone (623) 524-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51232AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Nov 1, 2015 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Nov 1, 2015 Accepting new patients
Banner del E Webb Medical Center Past Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1316184948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14502 W MEEKER BLVD",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755282",
            "telephone_number": "623-524-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 W MEEKER BLVD",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755282",
            "telephone_number": "623-524-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIREDDY",
        "first_name": "KRISHNA",
        "middle_name": "KISHOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "276270",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SD",
            "license": "7811",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "51232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006483",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.