Active NPI
Balasingam Thevakumar, MD
- Student in an Organized Health Care Education/Training Program
- Phoenix, AZ
National Provider Identifier
1336880657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- R79125
- Practice address
- 4120 N 108TH Ave Ste 116
Phoenix, AZ 85037-5773 - Phone
- (623) 872-1818
- NPI assigned
- Apr 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | R79125 | AZ | Primary |
Addresses
Primary practice location
4120 N 108TH Ave Ste 116
Phoenix, AZ 85037-5773
Mailing address
8245 N 27TH Ave Apt 204
Phoenix, AZ 85051-6369
Phone (916) 934-8724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R79125 | AZ | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1336880657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8245 N 27TH AVE APT 204",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850516369",
"telephone_number": "916-934-8724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 N 108TH AVE STE 116",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850375773",
"telephone_number": "623-872-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEVAKUMAR",
"first_name": "BALASINGAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-02",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": "R79125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.