Individual provider Active NPI

Rani Hantla, PSYD

  • Health Service Psychologist
  • Gilbert, AZ
National Provider Identifier
1962196253
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
PSY-005634 Issued in AZ
Practice address
2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone
(480) 634-3454
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X PSY-005634 AZ Primary

Addresses

Primary practice location

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165

Mailing address

1640 W Orchid LN
Chandler, AZ 85224-4081
Phone (480) 634-3454

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
I20230816002802 AZ Practitioner - Clinical Psychologist 3971965328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Cancer Center Specialists LLCGroup PAC ID 6103097779, 343 clinicians

Practice addresses (Care Compare)

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC CurrentSince Aug 2, 2023 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Aug 2, 2023 Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

925 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-4498

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

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.

Hospital & facility affiliations 2

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": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1962196253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 W ORCHID LN",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244081",
            "telephone_number": "480-634-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165",
            "telephone_number": "480-634-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANTLA",
        "first_name": "RANI",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "AZ",
            "license": "PSY-005634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.