Individual provider Active NPI

Pranamya Mahankali, DO

  • Surgical Critical Care Physician
  • Tucson, AZ
National Provider Identifier
1740772060
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
1740772060 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-1354
Phone
(520) 626-7747
NPI assigned
Jun 1, 2018
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Critical Care Physician 2086S0102X 1740772060 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-1354

Mailing address

1501 N Campbell Ave RM 5301
Tucson, AZ 85724-5058

Other practice location 1

42 E Laurel Rd Ste 2600
Stratford, NJ 08084-1354
Phone (856) 566-6875

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
I20250508001597 AZ Practitioner - General Surgery 5799202149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Liberty Univ College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1740772060AZMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jun 16, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Jun 16, 2025 Accepting new patients
Rowan University School of Osteopathic Medicine Past Accepting new patients

Locations

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

1501 N Campbell Ave
Rm 5301
Tucson, AZ 85724
Phone (520) 626-7221

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

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 4

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": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1740772060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE RM 5301",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857241354",
            "telephone_number": "520-626-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 E Laurel Rd Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841354",
            "country_code": "US",
            "telephone_number": "856-566-6875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHANKALI",
        "first_name": "PRANAMYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2024-05-15",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AZ",
            "license": "1740772060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.