Individual provider Active NPI

Veena Vanmala Vats, MD

  • Facial Plastic Surgery Physician
  • Gilbert, AZ
National Provider Identifier
1760472567
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
34172 Issued in AZ
Practice address
3485 S Mercy Rd
Suite 103
Gilbert, AZ 85297-0429
Phone
(480) 558-3223
Fax
(480) 558-5152
NPI assigned
Oct 24, 2005
Last updated
Nov 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 34172 AZ Primary

Addresses

Primary practice location

3485 S Mercy Rd
Suite 103
Gilbert, AZ 85297-0429

Mailing address

3485 S Mercy Rd
Suite 104
Gilbert, AZ 85297-0429
Phone (480) 558-3223

Other identifiers 1

IdentifierTypeStateIssuer
212627MedicaidAZ

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
I20051008000184 AZ Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 2961427935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity ENT and Facial Aesthetics LLCGroup PAC ID 1052459716, 2 clinicians

Practice addresses (Care Compare)

1760 E Pecos Rd
Suite 401
Gilbert, AZ 85295-3204
Phone (480) 558-3223

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34172AZMDFacial Plastic Surgery Physician

Organizations & group practices 1

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 1

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1760472567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 S MERCY RD",
            "address_2": "SUITE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970429",
            "telephone_number": "480-558-3223",
            "fax_number": "480-558-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 S MERCY RD",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970429",
            "telephone_number": "480-558-3223",
            "fax_number": "480-558-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATS",
        "first_name": "VEENA",
        "middle_name": "VANMALA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AZ",
            "license": "34172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212627",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.