Jyoti Rajeev Walavalkar, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

D0059502 Issued in MD

Practice address

500N Hwy 89
Northern Arizona VA Health Care System
Prescott, AZ 86313

Phone

(928) 445-4860

NPI assigned

Jul 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770503385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500N HIGHWAY 89",
            "address_2": "NORTHERN ARIZONA VA HEALTH CARE SYTEMS ,",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500N HWY 89",
            "address_2": "NORTHERN ARIZONA VA HEALTH CARE SYSTEM",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALAVALKAR",
        "first_name": "JYOTI",
        "middle_name": "RAJEEV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0059502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole Eaton Wagner, FNP
• Gail Ann Wagner, M.S.
• Joy Wagner, RN
• Pamela Jean Wagner, LPC
• Wal-Mart Stores, Inc. (Vision Center 30-5303)
• Walgreen Co (Walgreens #09292)
• Walgreen Co (Walgreens #02555)
• Alan Paul Walicke, CCC-SLP
• Laurie Jill Walker, M.S.W.
• Lorna Ann Walker, PH.D., BCHN

• Geriatric Medicine (Internal Medicine) Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Geriatric Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.