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DR. RAJA SIREESHA GHANTASALA MBBS
NPI 1336721687
Pediatrics in Tucson, AZ

Active since April 26, 2021PECOS Enrolled
1925 W ORANGE GROVE RD STE 109, TUCSON, AZ 85704(520) 751-3675(520) 547-5767 Get Directions Write a Review

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

Record update history: Dec 19, 2024, Apr 26, 2021 (2 updates tracked since 2021).

About Dr. Raja Sireesha Ghantasala Mbbs NPPES

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

DR. RAJA SIREESHA GHANTASALA MBBS (NPI 1336721687) is an individual pediatrics provider in Tucson, Arizona, licensed in Arizona (73122) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336721687
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. RAJA SIREESHA GHANTASALACredential: MBBS
Location Address1925 W ORANGE GROVE RD STE 109Tucson, AZ 85704-1150
Mailing Address4801 E Broadway Blvd Ste 251Tucson, AZ 85711-2700 · (520) 327-0460
Phone(520) 751-3675
Fax(520) 547-5767
Sole ProprietorNo
Enumeration DateApril 26, 2021
Last NPPES UpdateJune 25, 20262 updates tracked since enumeration
NPPES CertifiedJune 25, 2026
✔ NPI 1336721687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AZ · 73122
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1925 W ORANGE GROVE RD STE 109, Tucson, AZ 85704
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Raja Sireesha Ghantasala Mbbs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Raja Sireesha Ghantasala reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Arizona Community Physicians PC
10 mi
Internal Medicine
5055 E BROADWAY BLVD, SUITE A100
Tucson, AZ 85711
  • Reassigned Medicare billing, Arizona enrollment
  • 264 clinicians in this Medicare group
NPI 1205871076 (520) 327-0460

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 85704 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

PHILIP J STARCESKI MD
Pediatrics
1925 W ORANGE GROVE RD STE 109
TUCSON, AZ 85704
Pima County (520) 751-3675
DR. KELSIE ELIZABETH OATMEN MD
Pediatrics
1925 W ORANGE GROVE RD STE 109
TUCSON, AZ 85704
Pima County (520) 751-3675

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 Raja Sireesha Ghantasala's NPI number?

The NPI number for Raja Sireesha Ghantasala is 1336721687. It was assigned to this individual provider in the NPPES registry on April 26, 2021.

Where is Raja Sireesha Ghantasala located?

Raja Sireesha Ghantasala practices at 1925 W Orange Grove Rd Ste 109, Tucson, AZ 85704. The listed phone number is (520) 751-3675.

What is Raja Sireesha Ghantasala's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Raja Sireesha Ghantasala enrolled in Medicare?

Yes. Raja Sireesha Ghantasala is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Raja Sireesha Ghantasala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raja Sireesha Ghantasala reassigns Medicare benefits to Arizona Community Physicians PC (Tucson, AZ). The 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 Raja Sireesha Ghantasala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Raja Sireesha Ghantasala accept?

Health plans from Blue Cross Blue Shield of Arizona list Raja Sireesha Ghantasala 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 Raja Sireesha Ghantasala was last updated on June 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.