NPIMap

Organization Active NPI

San Tan CVC Chandler

Doing business as San Tan Cardiovasular Center

  • Cardiovascular Disease Physician
  • Chandler, AZ
National Provider Identifier
1639567514
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25431 Issued in AZ
Legal business name
SAN TAN CVC CHANDLER
Doing business as
San Tan Cardiovasular Center
Practice address
3980 E Riggs Rd Ste 2
Chandler, AZ 85249-5413
Phone
(480) 895-0784
NPI assigned
Dec 31, 2014
Last updated
Dec 31, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN TAN CARDIOVASCULAR CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Authorized official

Name
Dr. Zelalem Yilma, MDNPI 1164421251
Title
Medical Director
Phone
(480) 390-3773

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
Cardiovascular Disease Physician 207RC0000X 25431 AZ Primary

Addresses

Primary practice location

3980 E Riggs Rd Ste 2
Chandler, AZ 85249-5413

Mailing address

3980 E Riggs Rd Ste 2
Chandler, AZ 85249-5413
Phone (480) 895-0784

Other names 1

  • San Tan Cardiovasular Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080603000052 AZ Part B Supplier - Clinic/Group Practice 7113097171 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gold Canyon, AZ; Mesa, AZ; Chandler, AZ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
San Tan Cardiovascular CNTR3 organizations share this tax ID, including this one
Part of
San Tan Cardiovascular CNTR

Other organizations with this tax ID 2

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHIEAA

Practitioners & affiliated clinicians

Practitioners 5

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": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1639567514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 E RIGGS RD STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495413",
            "telephone_number": "480-895-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 E RIGGS RD STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495413",
            "telephone_number": "480-895-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN TAN CVC CHANDLER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN TAN CARDIOVASCULAR CENTER",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "YILMA",
        "authorized_official_first_name": "ZELALEM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-390-3773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "25431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Tan Cardiovasular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.