Individual provider Active NPI

Sham M Vengurlekar, MD

  • Specialist
  • Phoenix, AZ
National Provider Identifier
1366401721
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20227 Issued in AZ
Practice address
7010 E Chauncey LN
Ste# 215
Phoenix, AZ 85054-3111
Phone
(480) 314-2288
Fax
(480) 314-1113
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20227 AZ Primary

Addresses

Primary practice location

7010 E Chauncey LN
Ste# 215
Phoenix, AZ 85054-3111

Mailing address

7010 E Chauncey LN
Ste# 215
Phoenix, AZ 85054-3111
Phone (480) 314-2288

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
I20051130000381 AZ Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 1254351638

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Omni MMT, LLC Past Accepting new patients
Omni Neuro Diagnostics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sham.vengurlekarmd.p41@direct.newportmed.nextgenshare.com
  • Direct secure messaging: sham.vengurlekarmd.p46@direct.newportmed.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1366401721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 E CHAUNCEY LN",
            "address_2": "STE# 215",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543111",
            "telephone_number": "480-314-2288",
            "fax_number": "480-314-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 E CHAUNCEY LN",
            "address_2": "STE# 215",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543111",
            "telephone_number": "480-314-2288",
            "fax_number": "480-314-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENGURLEKAR",
        "first_name": "SHAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "20227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.