Individual provider Active NPI

Kamaljeet Sachdeva, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1487751293
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36002 Issued in AZ
Practice address
635 East Baseline Road
Phoenix, AZ 85042-6551
Phone
(602) 243-7277
Fax
(602) 323-3349
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 36002 AZ Primary

Addresses

Primary practice location

635 East Baseline Road
Phoenix, AZ 85042-6551

Mailing address

2702 North 3Rd Street
Suite 4020
Phoenix, AZ 85004-4608
Phone (602) 323-3344

Other identifiers 1

IdentifierTypeStateIssuer
152960MedicaidAZ

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36002AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center Past Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients
Moon Valley Pediatrics PC Past Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients
Scottsdale Pediatrics and Pediatric Nephrology, PLLC Pediatrics Past Accepting new patients

Interoperability endpoints

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

Organizations & group practices 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1487751293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NORTH 3RD STREET",
            "address_2": "SUITE 4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044608",
            "telephone_number": "602-323-3344",
            "fax_number": "602-323-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 EAST BASELINE ROAD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277",
            "fax_number": "602-323-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHDEVA",
        "first_name": "KAMALJEET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "36002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152960",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.