Individual provider Active NPI

Supriya Nair, D.O.

  • Psychiatry Physician
  • Scottsdale, AZ
National Provider Identifier
1841328077
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4526 Issued in AZ
Practice address
4835 E Cactus Rd
Suite 333
Scottsdale, AZ 85254-4191
Phone
(602) 795-9980
Fax
(602) 795-9984
NPI assigned
Mar 1, 2007
Last updated
Sep 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4526 AZ Primary

Addresses

Primary practice location

4835 E Cactus Rd
Suite 333
Scottsdale, AZ 85254-4191

Mailing address

4835 E Cactus Rd
Suite 333
Scottsdale, AZ 85254-4191
Phone (602) 795-9980

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
I20070321000678 AZ Practitioner - Psychiatry 4688777162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
College of Osteopathic Physicians and Surgeons of Los Angeles, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health and Wellness LLCGroup PAC ID 3072801224, 4 clinicians

Practice addresses (Care Compare)

11801 N Tatum Blvd
Suite 128
Phoenix, AZ 85028-1620
Phone (602) 795-9980

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health & Wellness, LLC Psychiatry CurrentSince Jul 15, 2014 Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients

Locations

11801 N Tatum Blvd
Ste 128
Phoenix, AZ 85028
Phone (602) 795-9980

4835 E Cactus Rd
Ste 333
Scottsdale, AZ 85254
Phone (602) 795-9980

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1841328077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 E CACTUS RD",
            "address_2": "SUITE 333",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544191",
            "telephone_number": "602-795-9980",
            "fax_number": "602-795-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 E CACTUS RD",
            "address_2": "SUITE 333",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544191",
            "telephone_number": "602-795-9980",
            "fax_number": "602-795-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "SUPRIYA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "4526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.