NPIMap

Organization Active NPI

Siri Priyam, LLC

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1619389145
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37026 Issued in AZ
Legal business name
SIRI PRIYAM, LLC
Practice address
9515 W Camelback Rd
Suite 114
Phoenix, AZ 85037-1355
Phone
(623) 777-9108
Fax
(623) 455-9388
NPI assigned
Jun 2, 2014
Last updated
Jun 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Shantipriya Siripurapu, MDNPI 1740202860
Title
President/Owner
Phone
(623) 777-9108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37026 AZ Primary

Addresses

Primary practice location

9515 W Camelback Rd
Suite 114
Phoenix, AZ 85037-1355

Mailing address

9515 W Camelback Rd
Suite 114
Phoenix, AZ 85037-1355
Phone (623) 777-9108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140904001135 AZ Part B Supplier - Clinic/Group Practice 6901024959 Receives reassigned benefits from 9 practitioners
Practice locations: Phoenix, AZ; Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

9515 W Camelback Rd
Ste 114
Phoenix, AZ 85037
Phone (623) 777-1720

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1619389145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD",
            "address_2": "SUITE 114",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371355",
            "telephone_number": "623-777-9108",
            "fax_number": "623-455-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD",
            "address_2": "SUITE 114",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371355",
            "telephone_number": "623-777-9108",
            "fax_number": "623-455-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIRI PRIYAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "SIRIPURAPU",
        "authorized_official_first_name": "SHANTIPRIYA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "623-777-9108",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "37026",
            "primary": true
        }
    ],
    "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 Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.