Individual provider Active NPI

Archana Bansal, M.D.

  • Internal Medicine Physician
  • Sierra Vista, AZ
National Provider Identifier
1881663615
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35263 Issued in AZ
Practice address
157 N Coronado Dr
#C
Sierra Vista, AZ 85635-6360
Phone
(520) 458-4335
Fax
(520) 458-2988
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18964 MS
Internal Medicine Physician 207R00000X 35263 AZ Primary

Addresses

Primary practice location

157 N Coronado Dr
#C
Sierra Vista, AZ 85635-6360

Mailing address

157 N Coronado Dr
#C
Sierra Vista, AZ 85635-6360
Phone (520) 458-4335

Other identifiers 1

IdentifierTypeStateIssuer
098186MedicaidAZ

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
I20060808000226 AZ Practitioner - Internal Medicine 4981607173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

157 N Coronado Dr
Suite C
Sierra Vista, AZ 85635-6361
Phone (520) 458-0993

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Sierra Vista, AZ, CCN 037416
  • Haven Home Health Care Home health agency, Tucson, AZ, CCN 037494
  • Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18964MSMDFamily Medicine Physician
35263AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Vista Medical Center Internal Medicine CurrentSince Aug 31, 2012 Accepting new patients

Locations

157 N Coronado Dr
Ste C
Sierra Vista, AZ 85635
Phone (520) 458-0993

157 N Coronado Dr
Sierra Vista, AZ 85635
Phone (520) 308-1304

Interoperability endpoints

  • Direct secure messaging: archana.bansal.1@4594.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/4594/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 5

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1881663615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 N CORONADO DR",
            "address_2": "#C",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356360",
            "telephone_number": "520-458-4335",
            "fax_number": "520-458-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 N CORONADO DR",
            "address_2": "#C",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356360",
            "telephone_number": "520-458-4335",
            "fax_number": "520-458-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "ARCHANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18964",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "35263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098186",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.