Individual provider Active NPI

Rangadham Nagarakanti, MD

  • Clinical Cardiac Electrophysiology Physician
  • Cottonwood, AZ
National Provider Identifier
1790836252
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
67092 Issued in AZ
Practice address
269 S Candy LN
Cottonwood, AZ 86326-4158
Phone
(928) 634-1331
NPI assigned
Jan 12, 2007
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48585 KY
Internal Medicine Physician 207R00000X MD424922 PA
Cardiovascular Disease Physician 207RC0000X 25MA08495300 NJ
Cardiovascular Disease Physician 207RC0000X MD202854 LA
Cardiovascular Disease Physician 207RC0000X 48585 KY
Cardiovascular Disease Physician 207RC0000X MD424922 PA
Clinical Cardiac Electrophysiology Physician 207RC0001X 67092 AZ Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X R3562 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X 48585 KY

Addresses

Primary practice location

269 S Candy LN
Cottonwood, AZ 86326-4158

Mailing address

1200 N Beaver St
Attn: Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other practice location 1

1301 Pleasant Valley Rd
Suite 202
Owensboro, KY 42303-9774
Phone (270) 417-7500

Other practice location 2

2315 Myrtle St Ste 190
Erie, PA 16502-4604
Phone (814) 453-7767

Other practice location 3

636 Easton Ave
Somerset, NJ 08873-1975
Phone (732) 434-8975

Other practice location 4

707 E Marshall Ave
Longview, TX 75601-5545
Phone (903) 315-5400

Other identifiers 4

IdentifierTypeStateIssuer
0301825MedicaidNJ
153142MedicaidAZ
201338570MedicaidIN
1883182MedicaidLA

Other names 1

  • Randy Nagarakanti Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AZ, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20060109000469 PA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5092738765 Reassigns benefits to 1 organization
I20220830001484 AZ Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 5092738765 Reassigns benefits to 1 organization
I20221216000746 TX Practitioner - Cardiac Electrophysiology 5092738765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48585KYMDCardiovascular Disease Physician
MD202854LAMDCardiovascular Disease Physician
25MA08495300NJMDCardiovascular Disease Physician
R3562TXMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Feb 1, 2023 Accepting new patients
Christus Trinity Clinic Texas Multi-Specialty CurrentSince Dec 26, 2022 Accepting new patients
New Brunswick Cardiology Group, PA Multi-Specialty CurrentSince Jun 1, 2018 Accepting new patients
Northern Arizona Healthcare Corporation Multi-Specialty CurrentSince Feb 1, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 26, 2022 Accepting new patients
Saint Vincent Consultants in Cardiovascular Diseases Multi-Specialty CurrentSince Oct 24, 2022 Accepting new patients
Cardiojost, PLLC Multi-Specialty PastSince Sep 1, 2022 Accepting new patients
Community Hospital Group, Inc Multi-Specialty Past Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001
Phone (928) 213-1051

75 Veronica Ave
Ste 101
Somerset, NJ 08873
Phone (732) 247-5054

2315 Myrtle St
Ste 190
Erie, PA 16502
Phone (814) 453-7767

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

707 E Marshall Ave
Longview, TX 75601
Phone (903) 315-4880

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: rnagarakanti15051@epicdirect.rwjbh.org
  • Direct secure messaging: rnagarakanti646412@direct.honorhealth.com

Organizations & group practices 8

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 6

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1790836252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "ATTN: PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-634-1331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Pleasant Valley Rd",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423039774",
            "country_code": "US",
            "telephone_number": "270-417-7500",
            "fax_number": "270-417-7509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Myrtle St Ste 190",
            "address_purpose": "LOCATION",
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            "state": "PA",
            "postal_code": "165024604",
            "country_code": "US",
            "telephone_number": "814-453-7767",
            "fax_number": "814-454-6667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "636 Easton Ave",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "NJ",
            "postal_code": "088731975",
            "country_code": "US",
            "telephone_number": "732-434-8975",
            "fax_number": "732-876-0333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "707 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015545",
            "country_code": "US",
            "telephone_number": "903-315-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGARAKANTI",
        "first_name": "RANGADHAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "48585",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD424922",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08495300",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "MD202854",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "48585",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD424922",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "AZ",
            "license": "67092",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "R3562",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "KY",
            "license": "48585",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0301825",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153142",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201338570",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883182",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "NAGARAKANTI",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.