Individual provider Active NPI

Nandhini Marupudi, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1538555495
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
61020 Issued in AZ
Practice address
4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978
Phone
(602) 200-9021
Fax
(602) 200-9087
NPI assigned
Apr 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 61020 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 61020 AZ Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036144500 IL

Addresses

Primary practice location

4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978

Mailing address

1050 N Edgelawn Dr
Aurora, IL 60506-1860

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036144500ILMDPain Medicine (Anesthesiology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1538555495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N EDGELAWN DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 E ELWOOD ST STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401978",
            "telephone_number": "602-200-9021",
            "fax_number": "602-200-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUPUDI",
        "first_name": "NANDHINI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "61020",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "61020",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036144500",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jul 10, 2023; 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.