Individual provider Active NPI

Rushabh Kumar Daulat, MD

  • Student in an Organized Health Care Education/Training Program
  • Mesa, AZ
National Provider Identifier
1689464513
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
10238 E Hampton Ave Ste 411
Mesa, AZ 85209-3320
Phone
(480) 882-4750
Fax
(480) 882-5076
NPI assigned
May 12, 2025
Last updated
May 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary

Addresses

Primary practice location

10238 E Hampton Ave Ste 411
Mesa, AZ 85209-3320

Mailing address

1301 S Crismon Rd
Mesa, AZ 85209-3767

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724003178 AZ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7416464565

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1689464513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE STE 411",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093320",
            "telephone_number": "480-882-4750",
            "fax_number": "480-882-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAULAT",
        "first_name": "RUSHABH",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.