NPIMap

Organization Active NPI

Pleasant Pediatrics PLC

  • Pediatrics Physician
  • Glendale, AZ
National Provider Identifier
1619485489
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34320 Issued in AZ
Legal business name
PLEASANT PEDIATRICS PLC
Practice address
9980 W Glendale Ave Ste 130
Glendale, AZ 85307-3007
Phone
(623) 322-3380
NPI assigned
Jan 16, 2018
Organization subpart
Yes
Parent organization
PLEASANT PEDIATRICS PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Prasad Ravi
Title
Practice Manager
Phone
(623) 322-3380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 34320 AZ Primary

Addresses

Primary practice location

9980 W Glendale Ave Ste 130
Glendale, AZ 85307-3007

Mailing address

9059 W Lake Pleasant Pkwy Ste E540
Peoria, AZ 85382-8396

Other identifiers 1

IdentifierTypeStateIssuer
645732MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Pleasant Pediatrics PLC22 organizations share this tax ID, including this one
Part of
Pleasant Pediatrics PLC

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

9059 W Lake Pleasant Pkwy
Ste E540
Peoria, AZ 85382
Phone (623) 234-3283

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1619485489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY STE E540",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 W GLENDALE AVE STE 130",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853073007",
            "telephone_number": "623-322-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT PEDIATRICS PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLEASANT PEDIATRICS PLC",
        "enumeration_date": "2018-01-16",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "RAVI",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "623-322-3380"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "34320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645732",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.