Individual provider Active NPI

Vijay S Gill, MD

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1689647547
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22590 Issued in AZ
Practice address
2152 S Vineyard
Suite 119
Mesa, AZ 85210-6871
Phone
(480) 964-1702
Fax
(480) 964-1737
NPI assigned
Feb 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22590 AZ Primary

Addresses

Primary practice location

2152 S Vineyard
Suite 119
Mesa, AZ 85210-6871

Mailing address

2152 S Vineyard
Suite 119
Mesa, AZ 85210-6871
Phone (480) 964-1702

Other identifiers 1

IdentifierTypeStateIssuer
354316MedicaidAZ

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
I20041021000884 AZ Practitioner - Internal Medicine 8224099395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2152 S Vineyard
Suite 119
Mesa, AZ 85210-6881

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Narendra P Myneni MD PC Past Accepting new patients

Organizations & group practices 2

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689647547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD",
            "address_2": "SUITE 119",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106871",
            "telephone_number": "480-964-1702",
            "fax_number": "480-964-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD",
            "address_2": "SUITE 119",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106871",
            "telephone_number": "480-964-1702",
            "fax_number": "480-964-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "VIJAY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "22590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354316",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.