Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Pavan Kumar Tiyyagura, MD

Individual provider Internal Medicine Physician · NPI 1366757361

Mr. Pavan Kumar Tiyyagura, MD is an Internal Medicine in Mesa, Arizona. Qualified in 2003, 23 years ago. Practices with Banner Hospital Based Physicians Arizona LLC, a 641-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
23
Licensed in
AZ
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1400 S Dobson Road Attn Amanda Gump/hospitalists
Mesa, AZ 85202
Phone: (480) 543-2034
Fax: (480) 543-2647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence 43692 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 43692 (AZ)

Record details

NPI number1366757361
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 13, 2010
Last updated in NPPESOctober 28, 2020
Certification dateOctober 28, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Banner Hospital Based Physicians Arizona Llc — 641 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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