Individual provider Active NPI

Gabriel Leyba Altamirano, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1013431212
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
10441 Issued in AZ
Practice address
2450 E River Rd
Tucson, AZ 85718-6526
Phone
(520) 795-7780
NPI assigned
Jul 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 10441 AZ Primary

Addresses

Primary practice location

2450 E River Rd
Tucson, AZ 85718-6526

Mailing address

260 S Pantano Rd
Tucson, AZ 85710-4132
Phone (520) 465-5990

Other practice location 1

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 327-5461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171103002883 AZ Practitioner - Nurse Practitioner 0244596484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurological Associates of TucsonGroup PAC ID 5092709527, 60 clinicians

Practice addresses (Care Compare)

2450 E River Rd
Tucson, AZ 85718-6526
Phone (520) 795-7750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10441AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Associates of Tucson CurrentSince Sep 26, 2017 Accepting new patients

Locations

2450 E River Rd
Tucson, AZ 85718
Phone (520) 795-7750

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDEECA/Endpoint/EDEECA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013431212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S PANTANO RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857104132",
            "telephone_number": "520-465-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "520-795-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122805",
            "country_code": "US",
            "telephone_number": "520-327-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTAMIRANO",
        "first_name": "GABRIEL",
        "middle_name": "LEYBA",
        "name_prefix": "Mr.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "10441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.