NPIMap

Individual provider Active NPI

Ajith Purush, MBBS, MD

  • Internal Medicine Physician
  • Prescott, AZ
National Provider Identifier
1699761437
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33680 Issued in AZ
Practice address
722 N Montezuma St
Prescott, AZ 86301-2002
Phone
(928) 237-9000
Fax
(928) 237-9011
NPI assigned
Sep 27, 2005
Last updated
Jan 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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 33680 AZ Primary

Addresses

Primary practice location

722 N Montezuma St
Prescott, AZ 86301-2002

Mailing address

722 N Montezuma St
Prescott, AZ 86301-2002
Phone (928) 237-9000

Other identifiers 2

IdentifierTypeStateIssuer
P00217872OtherRR MEDICARE
101416OtherAZMEDICARE ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050225000794 AZ Practitioner - General PracticePractitioner - Internal MedicinePractitioner - Hospitalist 9335192699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Hospitalist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ajith Purush MD PLCGroup PAC ID 0941494785, 2 clinicians

Practice addresses (Care Compare)

722 N Montezuma St
Apurva Advanced Medical Care
Prescott, AZ 86301-2002
Phone (928) 710-1533

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ajith Purush MD PLC Internal Medicine CurrentSince Sep 7, 2010 Accepting new patients
Naz Hospitalists Inc Hospitalist Past Accepting new patients
Banner Sun City Medical Group Past Accepting new patients

Locations

8751 N 51st Ave
Glendale, AZ 85302
Phone (832) 729-9684

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

722 N Montezuma St
Prescott, AZ 86301
Phone (928) 237-9000

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1699761437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 N MONTEZUMA ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012002",
            "telephone_number": "928-237-9000",
            "fax_number": "928-237-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 N MONTEZUMA ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012002",
            "telephone_number": "928-237-9000",
            "fax_number": "928-237-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURUSH",
        "first_name": "AJITH",
        "name_prefix": "Dr.",
        "credential": "MBBS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00217872",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  ID",
            "identifier": "101416",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.