Individual provider Active NPI

Arundathi P. Narayanappa, P.A.

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1679520522
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2015 Issued in AZ
Practice address
11034 N 23Rd Dr # 105B
Phoenix, AZ 85029-4743
Phone
(602) 639-0189
NPI assigned
May 27, 2006
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2015 AZ Primary

Addresses

Primary practice location

11034 N 23Rd Dr # 105B
Phoenix, AZ 85029-4743

Mailing address

4530 E Ray Rd
Suite #190
Phoenix, AZ 85044-6094
Phone (480) 940-5420

Other practice location 1

4530 E Ray Rd
Suite #190
Phoenix, AZ 85044-6094
Phone (480) 940-5420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823001035 AZ Practitioner - Physician Assistant 5496786089 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2015AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Skin and Laser Therapy Institue, LTD CurrentSince Mar 1, 2005 Accepting new patients
Arizona Skin and Laser Therapy Institute, LTD CurrentSince Mar 1, 2005 Accepting new patients
Physician Group of Arizona Inc CurrentSince Feb 4, 2012 Accepting new patients
Total Orthopedics,LLC Past Accepting new patients
Shelly a Friedman Past Accepting new patients
Advanced Dermatology of Arizona, PC PastSince Oct 3, 2015 Accepting new patients

Locations

10238 E Hampton Ave
Ste 404
Mesa, AZ 85209
Phone (480) 771-7546

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

2224 W Northern Ave
Ste D300
Phoenix, AZ 85021
Phone (602) 277-1449

4530 E Ray Rd
Ste 190
Phoenix, AZ 85044
Phone (480) 785-0305

4835 E Cactus Rd
Ste 155
Scottsdale, AZ 85254
Phone (602) 996-3050

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1679520522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD",
            "address_2": "SUITE #190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446094",
            "telephone_number": "480-940-5420",
            "fax_number": "480-940-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11034 N 23RD DR # 105B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294743",
            "telephone_number": "602-639-0189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4530 E Ray Rd",
            "address_2": "Suite #190",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850446094",
            "country_code": "US",
            "telephone_number": "480-940-5420",
            "fax_number": "480-940-5480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NARAYANAPPA",
        "first_name": "ARUNDATHI",
        "middle_name": "P.",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.