Active NPI
Dheerendranath Raikhelkar II, MD
- Psychiatry Physician
- Phoenix, AZ
National Provider Identifier
1629178249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25650
- Practice address
- 2601 E Roosevelt St
Phoenix, AZ 85008-4973 - Phone
- (602) 344-5418
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25650 | AZ | Primary |
Addresses
Primary practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
3255 E Elwood St
#110
Phoenix, AZ 85034-7256
Phone (602) 470-5043
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25650 | AZ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magellan Health Services of Arizona, Inc | Past | Accepting new patients | |
| District Medical Group, Inc | Family Medicine | Past | Accepting new patients |
| Vo of Arizona, Inc. | 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 and National Provider Directory roles.
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- NPI 1447458682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629178249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3255 E ELWOOD ST",
"address_2": "#110",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850347256",
"telephone_number": "602-470-5043",
"fax_number": "602-470-5064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 E ROOSEVELT ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850084973",
"telephone_number": "602-344-5418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIKHELKAR",
"first_name": "DHEERENDRANATH",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "25650",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.