Individual provider Active NPI

Sri Raghav Sista, M.D.,M.S

  • Clinical Neurophysiology Physician
  • Scottsdale, AZ
National Provider Identifier
1861945818
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
T5036 Issued in TX
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone
(713) 500-8935
NPI assigned
Jul 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X T5036 TX
Neurology Physician 2084N0400X 67346 MN
Neurology Physician 2084N0400X 69526 AZ
Clinical Neurophysiology Physician 2084N0600X T5036 TX Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Other practice location 1

6410 Fannin St Ste 1014
Houston, TX 77030-5301
Phone (832) 325-7080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssista1215754@ehrdirect.mayoclinicmsg.org

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
I20240125004028 AZ Practitioner - Neurology 3971890997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Texas Southwestern Medical School at Dallas, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
68.75
Promoting interoperability
100
Improvement activities
40
Cost
72.66

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69526AZMDNeurology Physician
T5036TXMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Jan 12, 2024 Accepting new patients
Mayo Clinic Arizona CurrentSince Jan 12, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1861945818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "713-500-8935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 Fannin St Ste 1014",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770305301",
            "country_code": "US",
            "telephone_number": "832-325-7080",
            "fax_number": "713-512-2239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISTA",
        "first_name": "SRI RAGHAV",
        "name_prefix": "Dr.",
        "credential": "M.D.,M.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "TX",
            "license": "T5036",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "67346",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "69526",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "T5036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssista1215754@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.