DR. TANESH KUMAR AYYALU MD
NPI 1639707441
Student in an Organized Health Care Education/Training Program in Forest Hills, NY

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 28, 2020PECOS Enrolled

10201 66TH RD, FOREST HILLS, NY 11375(718) 830-4352 Get Directions Write a Review

NPPES record last updated: March 28, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Tanesh Kumar Ayyalu Md NPPES

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

DR. TANESH KUMAR AYYALU MD (NPI 1639707441) is an individual student in an organized health care education/training program in Forest Hills, New York and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639707441

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. TANESH KUMAR AYYALUCredential: MD

Location Address10201 66TH RDForest Hills, NY 11375-2029

Mailing Address10201 66th RdForest Hills, NY 11375-2029 · (718) 830-4352

Phone(718) 830-4352

Sole ProprietorYes

Enumeration DateMarch 28, 2020

NPPES CertifiedMarch 28, 2020

✔ NPI 1639707441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

10201 66TH RD, Forest Hills, NY 11375

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tanesh Kumar Ayyalu Md 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.