EAST VALLEY KIDNEY SPECIALIST PLLC HEALTH CARE
NPI 1619766789
Internal Medicine - Nephrology in Mesa, AZ
About East Valley Kidney Specialist Pllc Health Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST VALLEY KIDNEY SPECIALIST PLLC HEALTH CARE (NPI 1619766789) is a healthcare organization registered as a nephrology in Mesa, Arizona and active in the NPI registry since May 2025. The organization maintains a secondary practice location in Tempe and lists Sandeep Mallanagouda Patil, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
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 Kidney Specialist Pllc Health Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to East Valley Kidney Specialist PLLC Health Care, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Kidney Specialist PLLC Health Care's NPI number?
The NPI number for East Valley Kidney Specialist PLLC Health Care is 1619766789. It was assigned to this organization in the NPPES registry on May 5, 2025.
Where is East Valley Kidney Specialist PLLC Health Care located?
East Valley Kidney Specialist PLLC Health Care is located at 1910 S Stapley Dr Ste 120, Mesa, AZ 85204. The listed phone number is (602) 525-5674.
What is East Valley Kidney Specialist PLLC Health Care's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is East Valley Kidney Specialist PLLC Health Care enrolled in Medicare?
Yes. East Valley Kidney Specialist PLLC Health Care is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through East Valley Kidney Specialist PLLC Health Care?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nephrology) reassigns their Medicare billing to East Valley Kidney Specialist PLLC Health Care. 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. 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 Kidney Specialist PLLC Health Care was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# East Valley Kidney Specialist Pllc Health Care · NPI 1619766789
Nephrology organization in Mesa, Arizona. Organization record, active in the CMS NPPES registry since May 5, 2025.
## Identity
- **NPI:** 1619766789 (Entity type: Organization)
- **Enumerated:** May 5, 2025
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Sandeep Patil, CEO
## Practice location
- **Address:** 1910 S STAPLEY DR STE 120, Mesa, AZ 85204-6676
- **Phone:** (602) 525-5674
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nephrology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1619766789) · Data from the CMS NPPES public registry.