Individual provider Active NPI

Amol Nanak Rakkar, M.D.

  • Specialist
  • Glendale, AZ
National Provider Identifier
1336160241
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
29566 Issued in AZ
Practice address
5601 W Eugie Ave Ste 106
Glendale, AZ 85304-1256
Phone
(602) 978-6255
Fax
(602) 564-9286
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 29566 AZ Primary

Addresses

Primary practice location

5601 W Eugie Ave Ste 106
Glendale, AZ 85304-1256

Mailing address

26202 N 47TH Dr
Glendale, AZ 85310-1677

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
I20101101000380 AZ Practitioner - Hematology/Oncology 2668688557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Palo Verde Hematology Oncology LTDGroup PAC ID 6406840131, 7 clinicians

Practice addresses (Care Compare)

16641 N 40TH St
Suite 2
Phoenix, AZ 85032-3343
Phone (602) 978-6255

9250 W Thomas Rd
Suite 150
Phoenix, AZ 85037-3382
Phone (623) 478-8091

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
  • Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115
  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29566AZMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Verde Hematology Oncology LTD. Specialist CurrentSince Nov 1, 2001 Accepting new patients
Arizona Digestive Health, PC Past Accepting new patients

Locations

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

7410 N Zanjero Blvd
Glendale, AZ 85305
Phone (602) 375-6230

5601 W Eugie Ave
Ste 106
Glendale, AZ 85304

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

16641 N 40th St
Ste 2
Phoenix, AZ 85032
Phone (602) 482-2929

9250 W Thomas Rd
Ste 150
Phoenix, AZ 85037
Phone (623) 478-8091

1661 E Camelback Rd
Ste 375
Phoenix, AZ 85016

10460 N 92nd St
Ste 402
Scottsdale, AZ 85258
Phone (480) 860-2540

Organizations & group practices 2

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 3

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336160241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26202 N 47TH DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853101677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W EUGIE AVE STE 106",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041256",
            "telephone_number": "602-978-6255",
            "fax_number": "602-564-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKKAR",
        "first_name": "AMOL",
        "middle_name": "NANAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "29566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.