NPIMap

Individual provider Active NPI

Ajay Neilchand Yeddu I, MD

  • Interventional Pain Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1871553529
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
34866 Issued in AZ
Practice address
1410 W Guadalupe Rd
Building 4 Suite 125
Gilbert, AZ 85233-3003
Phone
(480) 838-1914
Fax
(480) 838-9434
NPI assigned
Mar 26, 2006
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34866 AZ
Anesthesiology Physician 207L00000X MD-15499R LA
Interventional Pain Medicine Physician 208VP0014X 34866 AZ Primary

Addresses

Primary practice location

1410 W Guadalupe Rd
Building 4 Suite 125
Gilbert, AZ 85233-3003

Mailing address

PO Box 97
Higley, AZ 85236-0097
Phone (480) 838-1914

Other identifiers 3

IdentifierTypeStateIssuer
1423360MedicaidLA
34866OtherAZAZ STATE LICENSE
081425MedicaidAZ

Other names 1

  • Ajay Neilchand Yeddu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060921000520 AZ Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 4789652959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Interventional Spine ConsultantsGroup PAC ID 0941499404, 2 clinicians

Practice addresses (Care Compare)

1410 W Guadalupe Rd
Suite 125
Gilbert, AZ 85233-3041
Phone (480) 838-1914

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as individual
Quality
83.22
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34866AZMDAnesthesiology Physician
MD-15499RLAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Interventional Spine Consultants CurrentSince Aug 1, 2010 Accepting new patients
Sheridan Healthcare of Arizona Inc Anesthesiology Past Accepting new patients
Arizona Advanced Health Services LLC Past Accepting new patients
TMC Medical Network Past Accepting new patients

Locations

1410 W Guadalupe Rd
Ste 125
Gilbert, AZ 85233
Phone (480) 838-1914

2058 S Dobson Rd
Ste 2
Mesa, AZ 85202
Phone (480) 838-1914

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGIDBA

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1143331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1871553529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "HIGLEY",
            "state": "AZ",
            "postal_code": "852360097",
            "telephone_number": "480-838-1914",
            "fax_number": "480-838-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W GUADALUPE RD",
            "address_2": "BUILDING 4 SUITE 125",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333003",
            "telephone_number": "480-838-1914",
            "fax_number": "480-838-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEDDU",
        "first_name": "AJAY",
        "middle_name": "NEILCHAND",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "34866",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD-15499R",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AZ",
            "license": "34866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1423360",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE LICENSE",
            "identifier": "34866",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081425",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AJAY",
            "last_name": "YEDDU",
            "middle_name": "NEILCHAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.