Individual provider Active NPI

Ranjit Isaac Kylathu, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1669423877
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
43192 Issued in AZ
Practice address
5301 E Grant Rd
Tucson, AZ 85712-2805
Phone
(520) 324-5461
Fax
(520) 324-1406
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 43699 OK
Neonatal-Perinatal Medicine Physician 2080N0001X 39913 TN
Neonatal-Perinatal Medicine Physician 2080N0001X 43192 AZ Primary

Addresses

Primary practice location

5301 E Grant Rd
Tucson, AZ 85712-2805

Mailing address

12977 N Via Vista del Pasado
Oro Valley, AZ 85755-5988
Phone (620) 237-7656

Other practice location 1

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-6135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100817000932 AZ Practitioner - Pediatric Medicine 3375563729 Reassigns benefits to 1 organization
I20251022001849 TN Practitioner - Pediatric Medicine 3375563729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1021 W Oakland Ave
Suite 310
Johnson City, TN 37604-2192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43192AZMDNeonatal-Perinatal Medicine Physician
39913TNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Sep 1, 2024 Accepting new patients
Medical Education Assistance Corporation Pediatrics CurrentSince Oct 1, 2025 Accepting new patients
Tucson Medical Center Past Accepting new patients
Mountain States Health Alliance Past Accepting new patients

Locations

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1669423877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12977 N VIA VISTA DEL PASADO",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857555988",
            "telephone_number": "620-237-7656",
            "fax_number": "520-237-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-324-5461",
            "fax_number": "520-324-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6161 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361902",
            "country_code": "US",
            "telephone_number": "918-502-6135",
            "fax_number": "918-502-6137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KYLATHU",
        "first_name": "RANJIT",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OK",
            "license": "43699",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TN",
            "license": "39913",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "43192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.