Individual provider Active NPI

Ramaswamy Kavitha Perumparaichallai, PH.D.

  • Clinical Neuropsychologist
  • Phoenix, AZ
National Provider Identifier
1851689376
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
4203 Issued in AZ
Practice address
2400 N Central Ave Ste 204
Phoenix, AZ 85004-1341
Phone
(623) 295-9119
Fax
(888) 819-1123
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4203 AZ Primary

Addresses

Primary practice location

2400 N Central Ave Ste 204
Phoenix, AZ 85004-1341

Mailing address

530 E McDowell Rd Ste 107-427
Phoenix, AZ 85004-1549
Phone (602) 935-7152

Other identifiers 1

IdentifierTypeStateIssuer
651365MedicaidAZ

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000924 AZ Practitioner - Clinical Psychologist 5395910806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2400 N Central Ave
Phoenix, AZ 85004-1341
Phone (602) 935-7152

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prkay & Associates PLLC Clinical Neuropsychologist CurrentSince Aug 1, 2022 Accepting new patients
Dignity Health PastSince Oct 4, 2011 Accepting new patients

Locations

2400 N Central Ave
Ste 204
Phoenix, AZ 85004
Phone (602) 935-7152

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1851689376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E MCDOWELL RD STE 107-427",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041549",
            "telephone_number": "602-935-7152",
            "fax_number": "888-819-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N CENTRAL AVE STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041341",
            "telephone_number": "623-295-9119",
            "fax_number": "888-819-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUMPARAICHALLAI",
        "first_name": "RAMASWAMY KAVITHA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "4203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651365",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.