Individual provider Active NPI

Roxanna Behnejad

  • Medical Physician Assistant
  • Tucson, AZ
National Provider Identifier
1033649017
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8443 Issued in AZ
Practice address
350 N Wilmot Rd
Tucson, AZ 85711-2602
Phone
(520) 873-3077
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA60907702 WA
Medical Physician Assistant 363AM0700X 8443 AZ Primary

Addresses

Primary practice location

350 N Wilmot Rd
Tucson, AZ 85711-2602

Mailing address

350 N Wilmot Rd
Tucson, AZ 85711-2602

Other practice location 1

315 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1291

Other practice location 2

2450 E River Rd
Tucson, AZ 85718-6526
Phone (520) 887-3056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190219001517 WA Practitioner - Physician Assistant 3779821624 Reassigns benefits to 1 organization
I20210812003595 AZ Practitioner - Physician Assistant 3779821624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tucson Physician Group Holdings LLCGroup PAC ID 0547560070, 200 clinicians

Practice addresses (Care Compare)

395 N Silverbell Rd
Suite 355
Tucson, AZ 85745-2981
Phone (520) 622-5912

Hospital & facility affiliations

  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8443AZMDMedical Physician Assistant
PA60907702WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Physicians, Inc CurrentSince Jan 1, 2022 Accepting new patients
Multicare Health System CurrentSince Jan 21, 2019 Accepting new patients
Multicare Health System CurrentSince Jan 21, 2019 Accepting new patients
SMSJ Tucson Holdings LLC Past Accepting new patients

Locations

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 7

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 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1033649017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112602",
            "telephone_number": "520-873-3077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "98405",
            "country_code": "US",
            "telephone_number": "253-403-1291",
            "fax_number": "253-403-1374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2450 E River Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857186526",
            "country_code": "US",
            "telephone_number": "520-887-3056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEHNEJAD",
        "first_name": "ROXANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60907702",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.