Individual provider Active NPI

Vishal Gunnala

  • Pediatric Critical Care Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1497919179
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
51675 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-1784
Fax
(602) 933-4298
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 51675 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd
Phoenix, AZ 85016-7761
Phone (602) 933-1000

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
I20160519001150 AZ Practitioner - Critical Care (Intensivists) 9133418817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Creighton University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51675AZMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jul 1, 2016 Accepting new patients
TMC Medical Network CurrentSince Sep 1, 2017 Accepting new patients

Locations

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

1919 E Thomas Rd
Fl 5
Phoenix, AZ 85016

2108 E Thomas Rd
Phoenix, AZ 85016

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1497919179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167761",
            "telephone_number": "602-933-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-1784",
            "fax_number": "602-933-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNNALA",
        "first_name": "VISHAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "51675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.