| Ayesha Venkateswaran, | |
|
436 5th Avenue, Kotzebue, AK 99752-0043 | |
| (907) 442-3321 | |
| Not Available |
| Full Name | Ayesha Venkateswaran |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 13 Years |
| Location | 436 5th Avenue, Kotzebue, Alaska |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285047142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60746395 (Washington) | Secondary |
| 207Q00000X | Family Medicine | 69730 (Arizona) | Secondary |
| 208M00000X | Hospitalist | 2021048199 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chinle Comprehensive Health Care Facility | Chinle, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dhhs Phs Naihs Chinle Comprehensive Health Care Facility | 9436062585 | 146 |
| Entity Name | Tuba City Regional Health Care Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107 |
| Entity Name | Dhhs Phs Naihs Shiprock Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780639971 PECOS PAC ID: 0749193837 Enrollment ID: O20031105000809 |
| Entity Name | Dhhs Phs Naihs Chinle Comprehensive Health Care Facility |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508800129 PECOS PAC ID: 9436062585 Enrollment ID: O20031106000210 |
| Entity Name | Maniilaq Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861698805 PECOS PAC ID: 6103881792 Enrollment ID: O20041123000372 |
| Entity Name | Dhhs Ihs Phoenix Area |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356628028 PECOS PAC ID: 9436325420 Enrollment ID: O20120222000148 |
| Mailing Address | Practice Location Address |
|---|---|
| Ayesha Venkateswaran, Po Box 43, Kotzebue, AK 99752-0043 Ph: (907) 442-3321 | Ayesha Venkateswaran, 436 5th Avenue, Kotzebue, AK 99752-0043 Ph: (907) 442-3321 |