Artisan Primary Care, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35444 Issued in AZ

Legal business name

ARTISAN PRIMARY CARE, PLLC

Doing business as

Srinivasa Madala, MD

Practice address

14815 N del Webb Blvd
Sun City, AZ 85351-2145

Phone

(623) 277-0759

Fax

(623) 200-5519

NPI assigned

Jul 23, 2018

Last updated

Apr 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Srinivasa Madala, MDNPI 1851324891

Title

Physician

Phone

(623) 853-3437

Specialties & licenses 1

Addresses

Other names 1

• Srinivasa Madala, MD Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Srinivasa R Madala, MD

  • Internal Medicine Physician
  • Sun City, AZ
  • NPI 1851324891
  Medicare reassignment Care Compare group NPD Authorized official
• Ashley Johnson, PA-C

  • Medical Physician Assistant
  • West Valley City, UT
  • NPI 1083296081

  AZ

  Medicare reassignment Care Compare group
• Heike Hilker, RDN, PA-C

  • Physician Assistant
  • Laveen, AZ
  • NPI 1447708680
  Medicare reassignment
• Kaci Lynn Larson, PA-C

  • Physician Assistant
  • Eagan, MN
  • NPI 1932861879

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1962989962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14815 N DEL WEBB BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853512145",
            "telephone_number": "623-277-0759",
            "fax_number": "623-200-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14815 N DEL WEBB BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853512145",
            "telephone_number": "623-277-0759",
            "fax_number": "623-200-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTISAN PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "MADALA",
        "authorized_official_first_name": "SRINIVASA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "623-853-3437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "35444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Srinivasa Madala, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.