Individual provider Active NPI

Anthony Fernandez, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1023181377
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6390 E Broadway Blvd
Tucson, AZ 85710-3517
Phone
(520) 284-7949
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6390 E Broadway Blvd
Tucson, AZ 85710-3517

Mailing address

6390 E Broadway Blvd
Tucson, AZ 85710-3517
Phone (520) 284-7949

Other identifiers 1

IdentifierTypeStateIssuer
926446MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070323000020 AZ Practitioner - Clinical Social Worker 9739283292 Reassigns benefits to 3 organizations
I20220728000008 TX Practitioner - Clinical Social Worker 9739283292 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ton San Xavier Health Center CurrentSince Jun 3, 2022 Accepting new patients
Community Intervention Associates CurrentSince Sep 15, 2018 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Mar 29, 2021 Accepting new patients
Ton San Simon Health Center CurrentSince Jun 3, 2022 Accepting new patients
Community Intervention Associates, Inc. Current Accepting new patients
Quality of Life Medical Centers, LLC CurrentSince Mar 21, 2025 Accepting new patients
Solace Behavioral Health LLC CurrentSince May 28, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Community Intervention Assciates, Inc CurrentSince Sep 15, 2018 Accepting new patients
Ton Santa Rosa Health Center CurrentSince Jun 3, 2022 Accepting new patients
Ton Sells Hospital CurrentSince Jun 3, 2022 Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients
Ton Santa Rosa Health Center Past Accepting new patients

Locations

1326 W Highway 92
Ste J
Bisbee, AZ 85603
Phone (520) 366-3603

275 W Continental Rd
Ste 141
Green Valley, AZ 85622
Phone (520) 400-9229

1516 S Ocotillo Ave
Parker, AZ 85344
Phone (928) 669-5319

2550 W Union Hills Dr
Phoenix, AZ 85027
Phone (602) 358-0224

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

5390 E Erickson Dr
Tucson, AZ 85712
Phone (520) 314-1545

6390 E Broadway Blvd
Tucson, AZ 85710
Phone (520) 284-7949

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

5350 E Erickson Dr
Tucson, AZ 85712
Phone (520) 624-8935

6390 E Broadway Blvd
Ste 100
Tucson, AZ 85710
Phone (520) 284-7949

1773 W Saint Marys Rd
Ste 102
Tucson, AZ 85745
Phone (520) 622-8357

2851 S Avenue B
Bldg 4
Yuma, AZ 85364
Phone (928) 919-2436

Interoperability endpoints

  • Direct secure messaging: anthonyfernandez@tdh.allscriptsdirect.net

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1023181377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6390 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103517",
            "telephone_number": "520-284-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6390 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103517",
            "telephone_number": "520-284-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926446",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.