Active NPI
Satish S. Kumar, D.M.D.,M.D.SC.,M.S.
- Periodontics
- Mesa, AZ
National Provider Identifier
1811288384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D010104
- Practice address
- 5855 E Still Cir
Mesa, AZ 85206 - Phone
- (480) 248-8158
- NPI assigned
- May 2, 2011
- Last updated
- Oct 3, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orofacial Pain Dentistry | 1223X2210X | D010104 | AZ | |
| Oral Medicine Dentistry | 125Q00000X | D010104 | AZ | |
| Periodontics | 1223P0300X | D010104 | AZ | Primary |
Addresses
Primary practice location
5855 E Still Cir
Mesa, AZ 85206
Mailing address
5855 E Still Cir
Mesa, AZ 85206-3631
Phone (480) 248-8158
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D010104 | AZ | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salt River Pima-Maricopa Indian Community | Current | Accepting new patients | |
| Salt River Pima-Maricopa Indian Community | Current | Accepting new patients | |
| Austin Geriatric Specialists, PLLC | Past | Accepting new patients |
Locations
10901 E McDowell Rd
Scottsdale, AZ 85256
Phone (480) 278-7742
Interoperability endpoints
- https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4
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.
-
dba Salt River Integrated Health Care
- Community Health Clinic/Center
- Scottsdale, AZ
- NPI 1942668991
TX
-
dba Department of Health and Human Services
- Community Health Clinic/Center
- Scottsdale, AZ
- NPI 1538583125
-
- Geriatric Medicine (Internal Medicine) Physician
- Austin, TX
- NPI 1376575886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1811288384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5855 E STILL CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852063631",
"telephone_number": "480-248-8158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5855 E STILL CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "85206",
"telephone_number": "480-248-8158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUMAR",
"first_name": "SATISH",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.M.D.,M.D.SC.,M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-02",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223X2210X",
"taxonomy_group": "",
"desc": "Dentist, Orofacial Pain",
"state": "AZ",
"license": "D010104",
"primary": false
},
{
"code": "125Q00000X",
"taxonomy_group": "",
"desc": "Dentist, Oral Medicine",
"state": "AZ",
"license": "D010104",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AZ",
"license": "D010104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.