Organization Active NPI

Neena K Uppal MD PC

  • Family Medicine Physician
  • Surprise, AZ
National Provider Identifier
1790973006
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25660 Issued in AZ
Legal business name
NEENA K UPPAL MD PC
Practice address
14674 W Mountain View Blvd Ste 200
Surprise, AZ 85374
Phone
(623) 544-6860
Fax
(623) 544-6861
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Authorized official

Name
Neena K Uppal, MDNPI 1124133020
Title
Owner
Phone
(623) 544-6860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 25660 AZ Primary

Addresses

Primary practice location

14674 W Mountain View Blvd Ste 200
Surprise, AZ 85374

Mailing address

14674 W Mountain View Blvd Ste 200
Surprise, AZ 85374-2708
Phone (623) 544-6860

Other identifiers 1

IdentifierTypeStateIssuer
423533MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180604000809 AZ Part B Supplier - Clinic/Group Practice 6406111947 Receives reassigned benefits from 9 practitioners
Practice locations: Surprise, AZ

National Provider Directory

National Provider Directory

Locations

14674 W Mountain View Blvd
Ste 200
Surprise, AZ 85374
Phone (602) 510-7142

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1790973006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14674 W MOUNTAIN VIEW BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742708",
            "telephone_number": "623-544-6860",
            "fax_number": "623-544-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14674 W MOUNTAIN VIEW BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85374",
            "telephone_number": "623-544-6860",
            "fax_number": "623-544-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEENA K UPPAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "UPPAL",
        "authorized_official_first_name": "NEENA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-544-6860",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "25660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423533",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.