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DANIEL NETHALA M.D
NPI 1104359272
Urology in Gilbert, AZ

Active since April 06, 2017PECOS EnrolledAccepts Medicare Assignment
86.79/100
CMS Quality Rating
2946 E BANNER GATEWAY DR., GILBERT, AZ 85234(480) 256-6444(480) 256-3682 Get Directions Write a Review

NPPES record last updated: September 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 17, 2025, Sep 7, 2023 (2 updates tracked since 2023).

About Daniel Nethala M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DANIEL NETHALA M.D (NPI 1104359272) is an individual urology provider in Gilbert, Arizona, licensed in Arizona (76587) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1104359272
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameDANIEL NETHALACredential: M.D
Location Address2946 E BANNER GATEWAY DR.Gilbert, AZ 85234
Mailing Address2946 E Banner Gateway DrGilbert, AZ 85234-2165 · (480) 256-6444
Phone(480) 256-6444
Fax(480) 256-3682
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 6, 2017
Last NPPES UpdateSeptember 24, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2025
✔ NPI 1104359272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in AZ · 76587
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2946 E BANNER GATEWAY DR., Gilbert, AZ 85234
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Daniel Nethala M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517201080
PECOS Enrollment IDI20251013003053
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Daniel Nethala reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Banner Cancer Center Specialists LLC
21 mi
Oncology
2901 N CENTRAL AVE STE 160
Phoenix, AZ 85012
  • Reassigned Medicare billing, Arizona enrollment
  • 470 clinicians in this Medicare group
NPI 1518253152 (602) 747-4000
Johns Hopkins Community Physicians, Inc
1,955 mi
Skilled Nursing Facility
7929 WESTPARK DR
Tysons, VA 22102
  • Reassigned Medicare billing, District of Columbia and Maryland enrollments
  • Also billed through NPI 1689485963 (Maryland)
  • 691 clinicians in this Medicare group
NPI 1790631695 (571) 617-0200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85234 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.46
Promoting Interoperability97
Improvement Activities40
Cost72

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. STEFANIE LEE CRAGO ACNP-BC
Nurse Practitioner (Acute Care)
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
DR. PHILIPPE LANAUZE M.D.
Radiology (Vascular & Interventional Radiology)
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
MRS. MARISA KEHAUNANI ANDRADE NP
Nurse Practitioner (Acute Care)
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
ARSENA ELENA SMITH DNP, FNP-C
Nurse Practitioner
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
PAUL WINOGRAD MD
Surgery (Plastic and Reconstructive Surgery)
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
MRS. STEPHANIE ANN BURKS FNP
Nurse Practitioner (Family)
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
MARK ALLEN KNAPP PA-C
Physician Assistant
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444
SUZANNE O'ROURKE FNP
Nurse Practitioner (Family)
2946 E BANNER GATEWAY DR.
GILBERT, AZ 85234
Maricopa County (480) 256-6444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Daniel Nethala's NPI number?

The NPI number for Daniel Nethala is 1104359272. It was assigned to this individual provider in the NPPES registry on April 6, 2017.

Where is Daniel Nethala located?

Daniel Nethala practices at 2946 E Banner Gateway Dr., Gilbert, AZ 85234. The listed phone number is (480) 256-6444.

What is Daniel Nethala's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Daniel Nethala enrolled in Medicare?

Yes. Daniel Nethala is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Daniel Nethala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Nethala reassigns Medicare benefits to 2 organizations: Banner Cancer Center Specialists LLC (Phoenix, AZ) and Johns Hopkins Community Physicians, Inc (Tysons, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Daniel Nethala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Daniel Nethala accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Daniel Nethala as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Daniel Nethala was last updated on September 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.