Active NPI
Superna Kundra, M.D
- Psychiatry Physician
- Surprise, AZ
National Provider Identifier
1356503510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 54718
- Practice address
- 13985 W Grand Ave
Suite 101
Surprise, AZ 85374-3625 - Phone
- (612) 991-7462
- NPI assigned
- Jun 30, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 54718 | MN | Primary |
| Psychiatry Physician | 2084P0800X | 48522 | AZ |
Addresses
Primary practice location
13985 W Grand Ave
Suite 101
Surprise, AZ 85374-3625
Mailing address
13985 W Grand Avenure
Suite 101
Surprise, AZ 85374
Phone (623) 251-2963
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48522 | AZ | MD | Psychiatry Physician |
| 54718 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1356503510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13985 W GRAND AVENURE",
"address_2": "SUITE 101",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "85374",
"telephone_number": "623-251-2963",
"fax_number": "623-302-5793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13985 W GRAND AVE",
"address_2": "SUITE 101",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853743625",
"telephone_number": "612-991-7462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNDRA",
"first_name": "SUPERNA",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-30",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "54718",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "48522",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.