Individual provider Active NPI

Ebie Varghese, MD

  • Nephrology Physician
  • Tucson, AZ
National Provider Identifier
1376690792
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35839 Issued in AZ
Practice address
395 N Silverbell Rd Ste 209
Tucson, AZ 85745-2719
Phone
(520) 623-2642
Fax
(520) 623-6162
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35839 AZ Primary

Addresses

Primary practice location

395 N Silverbell Rd Ste 209
Tucson, AZ 85745-2719

Mailing address

2149 E Warner Rd
Suite 101
Tempe, AZ 85284-3494
Phone (480) 610-6100

Other identifiers 1

IdentifierTypeStateIssuer
711673MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190926000445 GA Practitioner - Nephrology 5597650010 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Kidney Specialists Nephrology CurrentSince Apr 26, 2023 Accepting new patients
Epic Kidney Center PC Nephrology CurrentSince Aug 1, 2019 Accepting new patients
Southwest Kidney Institute, PLC Nephrology Past Accepting new patients

Locations

960 Sanders Rd
Ste 700
Cumming, GA 30041
Phone (678) 272-3777

980 Johnson Fy Rd NE
Ste 420
Sandy Springs, GA 30342
Phone (404) 252-0256

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.396886

Organizations & group practices 3

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1376690792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 E WARNER RD",
            "address_2": "SUITE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843494",
            "telephone_number": "480-610-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N SILVERBELL RD STE 209",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452719",
            "telephone_number": "520-623-2642",
            "fax_number": "520-623-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "EBIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "35839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711673",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.