Shailaja Devi Koppolu, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

38119 Issued in AZ

Practice address

1850 N Central Ave
Suite 1600
Phoenix, AZ 85004-4633

Phone

(602) 744-4765

Fax

(602) 744-4799

NPI assigned

Nov 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Anesthesiology

Education

Albert Einstein College of Medicine of Yeshiva University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Valley Anesthesiology Consultants, Inc.

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1285660704
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Estrella Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1275566200
  Care Compare affiliation

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

{
    "created_epoch": "1164240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1902971880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "SUITE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "SUITE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPOLU",
        "first_name": "SHAILAJA",
        "middle_name": "DEVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-23",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "222589",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "38119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "355985",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Kopesky, COTA/L
• Walter Edwin Koppenbrink III, M.D.
• Sarah Koppenhoefer-Little, OTR/L
• Sameet Koppikar, DDS
• Zackery Kopping, DC
• Sampunarao Koppula, M.D.
• Lori A Kopulos, PA-C
• Felix Asiedu Koranteng, PMHNP
• Ron Steven Kordonowy, AT
• Matilda Kordonski

• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.