Dr. Komandoor Srivathsan
Internal Medicine (Clinical Cardiac Electrophysiology)

Address: 5777 E Mayo Blvd, Phoenix, AZ 85054-4502
Phone: 4803018000

Dr. Komandoor Srivathsan (NPI# 1316920242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1316920242
Entity Type Individual
Full Name Dr. Komandoor Srivathsan
Credential M.D.
Gender Male
Practice Address 5777 E Mayo Blvd
Phoenix
AZ 85054-4502
Practice Telephone 4803018000
Mailing Address 5777 E Mayo Blvd
Phoenix
AZ 85054-4502
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2005-11-23
Last Update Date 2017-11-02

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 207RC0000X Internal Medicine · Cardiovascular Disease Allopathic & Osteopathic Physicians 24301 AZ
Yes 207RC0001X Internal Medicine · Clinical Cardiac Electrophysiology Allopathic & Osteopathic Physicians 24301 AZ

Other Provider Identifier

State Identifier Issuer Type Code
AZ 359853 MEDICAID
AZ 110167428 OTHER RAILROAD MEDICARE
AZ 86080015085259A449 OTHER TRIWEST

Physician Overview

NPI 1316920242
PAC ID by PECOS 6709854417
Professional Enrollment ID I20101020000406
Full Name Komandoor Srivathsan
Organization Legal Name MAYO CLINIC ARIZONA
Phone Number 4803424200
Gender M
Credential MD
Graduation Year 1982
Primary Specialty CARDIAC ELECTROPHYSIOLOGY
Secondary Specialties CARDIOVASCULAR DISEASE (CARDIOLOGY), INTERNAL MEDICINE
Group Practice PAC ID 7012829930
Number of Group Practice Members 957
Accepts Medicare Assignment M
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
030103 MAYO CLINIC HOSPITAL

Office Location

Street Address 5777 E MAYO BLVD
City PHOENIX
State AZ
Zip Code 85054-4502

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043574130 David Gregory Pearson Surgery 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2012-07-03
1245710219 Cayley R Mcdowell Student in an Organized Health Care Education/Training Program 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2018-08-18
1063991818 Emily Sepper Physician Assistant 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2018-08-13
1730685009 Kade Soren Mcquivey Student in an Organized Health Care Education/Training Program 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2018-04-04
1992200828 Stephanie Kerr Occupational Therapist 5777 E Mayo Blvd, Phoenix, AZ 85054 2018-03-23
1487161733 Melissa Younkins Student in an Organized Health Care Education/Training Program 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2018-01-09
1083121511 Margaret Mccallen Pharmacist 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2018-01-05
1225556780 Stephen James Mcmahan Physician Assistant 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2017-09-05
1578085064 Daniel Iliev Angelov Student in an Organized Health Care Education/Training Program 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2017-07-17
1902329485 Conor Moran Student in an Organized Health Care Education/Training Program 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 2017-07-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992255301 Stephanie Gamber Registered Nurse 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 2016-10-10
1811176860 Desert Ridge Pediatric Dentistry Clinic/Center 5315 E. High Street, Suite 115, Phoenix, AZ 85054 2007-10-26
1528121266 Adam L Schwartz Physician Assistant 6970 E Chauncey Ln Ste 100, Phoenix, AZ 85054 2006-12-17
1902968639 Ryan David Schulze Chiropractor 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 2006-12-16
1477517423 Gary Betz II Md PC Internal Medicine 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 2006-04-14
1700863875 Thomas B Daniels Radiology 5881 E. Mayo Blvd, Phoenix, AZ 85054 2005-12-29
1770576241 Michelle Renee Kuhn Physician Assistant 6950 E Chauncey Ln, Phoenix, AZ 85054 2005-08-30
1609869981 Jeffrey Alan Smith Optometrist 18325 N Allied Way Ste 100, Phoenix, AZ 85054 2005-08-23
1497753750 Rajeev Agarwal Pediatrics 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 2005-07-11
1902315435 Stacie Attig Registered Nurse 5779 E Mayo Blvd, Phoenix, AZ 85054 2017-09-27
Find all providers in zip 85054

Taxonomy Information

Taxonomy Code 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386159606 Phoenix Area Cardiology and Electrophysiology LLC Internal Medicine 1331 N 7th St Ste 400, Phoenix, AZ 85006-2779 2017-12-08
1891795993 Ashok Garg Internal Medicine 4550 E Bell Rd Ste 158, Phoenix, AZ 85032-9382 2005-07-29
1427051929 Vijendra Swarup Internal Medicine 1848 E Thomas Rd Ste 100, Phoenix, AZ 85016-8112 2005-05-27
1992288567 Robert Lemery Internal Medicine 1848 E Thomas Rd, Ste 100, Phoenix, AZ 85016-8112 2018-09-10
1154660298 Scottsdale Healthcare Corp Internal Medicine 9250 N 3rd St, Suite 3010, Phoenix, AZ 85020-2437 2013-02-09
1073801627 Arrhythmia Associates of Arizona, Plc Internal Medicine 525 N 18th St, Ste 501, Phoenix, AZ 85006-4102 2011-07-18
1255642880 Advanced Cardiac Echo, LLC Internal Medicine 6036 N 19th Ave Ste 405, Phoenix, AZ 85015-2142 2010-06-29
1356663736 Swarup PC Internal Medicine 500 W Thomas Rd, Ste 750, Phoenix, AZ 85013-4224 2010-02-25
1083946917 Sushmitha Patibandla Internal Medicine 20414 N 27th Ave, Suite 300, Phoenix, AZ 85027-3250 2010-02-03
1043443237 District Medical Group, Inc Internal Medicine 2601 E Roosevelt St, Cardiology, Phoenix, AZ 85008-4973 2009-09-03
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Competitor

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City PHOENIX
Zip Code 85054

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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