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DR. KELLI RAYNELL FAVATA M.D. NPI 1184822348


NPI Information

NPI: 1184822348
Provider Name: DR. KELLI RAYNELL FAVATA, M.D.
Classification: Specialist/Technologist Cardiovascular - 246XC2903X
Entity Type: Individual

Specialization: Vascular Specialist

PECOS Registration: Yes

Address:
3420 S MERCY RD STE 211
GILBERT, AZ
ZIP 85297
Phone: (866) 974-2673
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DR. Kelli Raynell Favata, M.D. is a vascular specialist specialist technologist cardiovascular in Gilbert, AZ. DR. Kelli Raynell Favata, M.D. NPI is 1184822348. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3420 S MERCY RD STE 211
GILBERT, AZ
ZIP 85297-424
Phone: (866) 974-2673
Fax: (866) 939-2673

The NPI 1184822348 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • Removal of tissue from wounds per session (HCPCS:97597)
  • Ultrasound study of arteries of both arms and legs (HCPCS:93922)
  • Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)

The enumeration date for this NPI number is 7/10/2007 and was last updated on 9/30/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine45344ARIZONANo
2246XC2903XSpecialist/Technologist CardiovascularVascular Specialist45344ARIZONAYes
3207R00000XInternal Medicine30177SOUTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1654974MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.