Individual provider Active NPI

Andrew Ian Militante

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1023808474
Registry record updated Jul 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R81809 Issued in AZ
Practice address
655 N Alvernon Way Ste 228
Tucson, AZ 85711-1853
Phone
(520) 626-2551
Fax
(520) 694-1640
NPI assigned
May 8, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R81809 AZ Primary

Addresses

Primary practice location

655 N Alvernon Way Ste 228
Tucson, AZ 85711-1853

Mailing address

655 N Alvernon Way Ste 228
Tucson, AZ 85711-1853

Other practice location 1

3950 S Country Club Rd Ste 130
Tucson, AZ 85714-2203
Phone (520) 670-3909

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250711001876 AZ Order and Referring Only - Family PracticePractitioner - Family Practice 4183139991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R81809AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753488000000",
    "number": "1023808474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N ALVERNON WAY STE 228",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111853",
            "fax_number": "520-694-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N ALVERNON WAY STE 228",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111853",
            "telephone_number": "520-626-2551",
            "fax_number": "520-694-1640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 S Country Club Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857142203",
            "country_code": "US",
            "telephone_number": "520-670-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILITANTE",
        "first_name": "ANDREW IAN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-07-26",
        "certification_date": "2025-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R81809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.