Soumya Nagaraja, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

59666 Issued in AZ

Practice address

1450S Dobsonrd,
Ste B221
Mesa, AZ 85202-6770

Phone

(480) 827-5370

NPI assigned

Jul 5, 2014

Last updated

Jun 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD
• Banner Physician Super Specialists Arizona LLC

  • Nutrition Education Nutritionist
  • Mesa, AZ
  • NPI 1790337665
  NPD

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

{
    "created_epoch": "1404518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1316353873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD STE B221",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024745",
            "telephone_number": "480-827-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450S DOBSONRD,",
            "address_2": "STE B221",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026770",
            "telephone_number": "480-827-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGARAJA",
        "first_name": "SOUMYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-05",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "AZ",
            "license": "59666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maristela Y Nabong-Nillas, M.D.
• Thomas A Nack Jr., DMD
• Emily Naclerio, MD
• Naffa LLC (NAFFA Wellness)
• Naffa Wellness LLC
• Raghavendra Nagarur
• Victoria Nagle, OTD, OTR/L
• Sandeep Nagre, MD
• Ronald Alva Nagy, DPM
• Sher Naidoo, MD

• Pediatric Endocrinology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatric Endocrinology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.