Shanmugam Mukundan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

37254 Issued in AZ

Practice address

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004

Phone

(623) 876-5622

Fax

(623) 815-2931

NPI assigned

Aug 12, 2006

Last updated

Aug 31, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northside Rheumatology PLLC

  • Rheumatology Physician
  • Chicago, IL
  • NPI 1437860061
  NPD
• Banner Sun City Medical Group

  • Multi-Specialty Clinic/Center
  • Sun City, AZ
  • NPI 1902067200
  NPD (past)
• Medical Associates of Northern VA Inc

  • Cardiovascular Disease Physician
  • Arlington, VA
  • NPI 1942230826
  NPD (past)
• Rheumatology and Internal Medicine, PC

  dba Shanmugam Mukundan, MD

  • Internal Medicine Physician
  • Fairfax, VA
  • NPI 1043471949
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1730191610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 W THUNDERBIRD BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513004",
            "telephone_number": "623-876-5622",
            "fax_number": "623-815-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 W THUNDERBIRD BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513004",
            "telephone_number": "623-876-5622",
            "fax_number": "623-815-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKUNDAN",
        "first_name": "SHANMUGAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101229163",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "37254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "690545",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "8128136",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010151431",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "201020956",
            "identifier": "AETNA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS CAREFIRST NCA",
            "identifier": "K012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "13965",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "2128136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "8128136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "G0157201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "201020956",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mountain Anesthesia Providers PC
• Moustafa Banna MD PLLC
• Michelle Lucille Mozart, PT
• Ms Physicians Group, PC
• Karla Ann Mueller-Schrader, PH.D.
• Madhavi Mulpuri, M.D
• Victor J Munoz Cabrera, FNP-C
• Danielle Marie Munoz
• Cristina Maria Murgiuc, MD
• Mujo Music, CRNA

• Internal Medicine Physician in Sun City, AZ
• Providers in Sun City, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.