Individual provider Active NPI

Amita D Trivedi, MD

  • Nephrology Physician
  • Tucson, AZ
National Provider Identifier
1578559233
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
12415 Issued in AZ
Practice address
395 N Silverbell Rd
Suite 209
Tucson, AZ 85745-2675
Phone
(520) 623-2642
Fax
(520) 623-6162
NPI assigned
Sep 27, 2005
Reactivated
Apr 5, 2006
Last updated
Jun 19, 2012By the provider in NPPES
Sex
Female
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 12415 AZ Primary

Addresses

Primary practice location

395 N Silverbell Rd
Suite 209
Tucson, AZ 85745-2675

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
203018MedicaidAZ

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
12415AZMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Amita D Trivedi MD Nephrology PastSince Jan 1, 1990 Accepting new patients
Southwest Kidney Institute, PLC Nephrology Past Accepting new patients
Northwest Allied Physicians, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1578559233",
    "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",
            "address_2": "SUITE 209",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452675",
            "telephone_number": "520-623-2642",
            "fax_number": "520-623-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "AMITA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2012-06-19",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "12415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203018",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.