Individual provider Active NPI

Shyamala Kumar, MD

  • Neurology Physician
  • Glendale, AZ
National Provider Identifier
1457314841
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
28250 Issued in AZ
Practice address
6677 W Thunderbird Rd
Ste D148
Glendale, AZ 85306-3769
Phone
(602) 843-3811
Fax
(602) 843-0044
NPI assigned
Apr 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 28250 AZ Primary

Addresses

Primary practice location

6677 W Thunderbird Rd
Ste D148
Glendale, AZ 85306-3769

Mailing address

6677 W Thunderbird Rd
Ste D148
Glendale, AZ 85306-3769
Phone (602) 843-3811

Other practice location 1

5757 W Thunderbird Rd
Suite E151
Glendale, AZ 85306-4685
Phone (602) 843-3811

Other identifiers 2

IdentifierTypeStateIssuer
7728238MedicaidAZ
569353MedicaidAZ

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
I20120323000278 AZ Practitioner - Neurology 3173783479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6677 W Thunderbird Rd
Suite D148
Glendale, AZ 85306-3769
Phone (602) 843-3811

Merit-based Incentive Payment System (MIPS)

Final score
93.12 of 100Reported as group
Quality
95
Improvement activities
40
Cost
81.42

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGGFCD/Endpoint/IGGFCD

Organizations & group practices 1

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1457314841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD",
            "address_2": "STE D148",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063769",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD",
            "address_2": "STE D148",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063769",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5757 W Thunderbird Rd",
            "address_2": "Suite E151",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064685",
            "country_code": "US",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SHYAMALA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "28250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7728238",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569353",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.