EAST VALLEY INFECTIOUS DISEASE MEDICINE LLC
NPI 1508643628
Internal Medicine - Infectious Disease in Mesa, AZ

Active since September 12, 2023
6040 E MAIN ST # 516, MESA, AZ 85205(480) 648-7895(623) 552-3320 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 10, 2025, Dec 13, 2024 (2 updates tracked since 2024).

About East Valley Infectious Disease Medicine Llc NPPES

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

EAST VALLEY INFECTIOUS DISEASE MEDICINE LLC (NPI 1508643628) is a healthcare organization registered as an infectious disease in Mesa, Arizona and active in the NPI registry since September 2023. The organization lists Shashikala Ameneni, Authorized Signer, as its authorized official.

NPPES Registry Identity

NPI1508643628
Entity TypeOrganization
Primary Taxonomy207RI0200X
Legal Business NameEAST VALLEY INFECTIOUS DISEASE MEDICINE LLC
Location Address6040 E MAIN ST # 516Mesa, AZ 85205-8928
Mailing AddressEvidm Lockbox Dept 880778, Po Box 29650Phoenix, AZ 85038-9650 · (480) 648-7895 · Fax (623) 552-3320
Fax(623) 552-3320
Organization SubpartNo
Authorized OfficialShashikala AmeneniAuthorized Signer · (480) 648-7895
Enumeration DateSeptember 12, 2023
Last NPPES UpdateApril 23, 20252 updates tracked since enumeration
NPPES CertifiedApril 23, 2025
✔ NPI 1508643628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
6040 E MAIN ST # 516, Mesa, AZ 85205

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

East Valley Infectious Disease Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to East Valley Infectious Disease Medicine LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Infectious Disease
NPI 1346229895
6040 E MAIN ST # 516
Mesa, AZ 85205
(480) 648-7895
✔ PECOS✔ Accepts MedicareSame address
Infectious Disease
NPI 1356463160
6644 E BAYWOOD AVE
Mesa, AZ 85206
(480) 321-2000
✔ PECOS✔ Accepts Medicare0.8 mi
Infectious Disease
NPI 1215020052
6644 E BAYWOOD AVE
Mesa, AZ 85206
(480) 384-0585
✔ PECOS✔ Accepts Medicare0.8 mi
Infectious Disease
NPI 1649293895
1400 S DOBSON RD
Mesa, AZ 85202
(480) 412-3000
✔ PECOS✔ Accepts Medicare10 mi
Internal Medicine
NPI 1669432118
4530 E MUIRWOOD DR 105
Phoenix, AZ 85048
(480) 961-2303
✔ PECOS✔ Accepts Medicare18 mi
Infectious Disease
NPI 1780962431
1324 LAKELAND HILLS BLVD
Lakeland, FL 33805
(863) 687-1100
✔ PECOS✔ Accepts Medicare1,802 mi

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

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 East Valley Infectious Disease Medicine LLC's NPI number?

The NPI number for East Valley Infectious Disease Medicine LLC is 1508643628. It was assigned to this organization in the NPPES registry on September 12, 2023.

Where is East Valley Infectious Disease Medicine LLC located?

East Valley Infectious Disease Medicine LLC is located at 6040 E Main St # 516, Mesa, AZ 85205. The listed phone number is (480) 648-7895.

What is East Valley Infectious Disease Medicine LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is East Valley Infectious Disease Medicine LLC enrolled in Medicare?

Yes. East Valley Infectious Disease Medicine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Valley Infectious Disease Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to East Valley Infectious Disease Medicine LLC. A 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 the clinician's services. The largest specialties are Infectious Disease (5) and Internal Medicine (1). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for East Valley Infectious Disease Medicine LLC was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.