NPIMap

Organization Active NPI

Lifetime Cardiovascular, PLC

  • Interventional Cardiology Physician
  • Chandler, AZ
National Provider Identifier
1356771661
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
LIFETIME CARDIOVASCULAR, PLC
Practice address
2100 E Yeager Dr
Chandler, AZ 85286-1598
Phone
(480) 699-5536
Fax
(480) 699-9283
NPI assigned
Nov 22, 2013
Last updated
Mar 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Authorized official

Name
Gautam KediaNPI 1518179373
Title
Owner/Physician
Phone
(480) 699-5536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 44342 AZ
Interventional Cardiology Physician 207RI0011X Primary
Nuclear Cardiology Physician 207UN0901X

Addresses

Primary practice location

2100 E Yeager Dr
Chandler, AZ 85286-1598

Mailing address

2487 S Gilbert Rd Ste 106-486
Gilbert, AZ 85295-8899
Phone (480) 699-5536

Other practice location 1

3011 S Lindsay Rd Ste 105
Gilbert, AZ 85295-4333
Phone (480) 699-5536

Other practice location 2

895 S Dobson Rd Ste 1
Chandler, AZ 85224-5721
Phone (480) 699-5536

Other identifiers 1

IdentifierTypeStateIssuer
872220MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140325001940 AZ Part B Supplier - Clinic/Group Practice 3274764816 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
Practice locations: Gilbert, AZ; Chandler, AZ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2487 S Gilbert Rd
Gilbert, AZ 85295
Phone (480) 722-5386

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1356771661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD STE 106-486",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958899",
            "telephone_number": "480-699-5536",
            "fax_number": "480-699-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E YEAGER DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861598",
            "telephone_number": "480-699-5536",
            "fax_number": "480-699-9283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3011 S Lindsay Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852954333",
            "country_code": "US",
            "telephone_number": "480-699-5536",
            "fax_number": "480-699-9283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "895 S Dobson Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245721",
            "country_code": "US",
            "telephone_number": "480-699-5536",
            "fax_number": "480-699-9283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFETIME CARDIOVASCULAR, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "KEDIA",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "480-699-5536"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "44342",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "872220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.