Individual provider Active NPI

Carli Shea Ogle, DO

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1053994525
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R3576 Issued in AZ
Practice address
707 N Alvernon Way Ste 101
Tucson, AZ 85711-1830
Phone
(520) 694-8888
NPI assigned
May 3, 2021
Last updated
May 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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 R3576 AZ Primary

Addresses

Primary practice location

707 N Alvernon Way Ste 101
Tucson, AZ 85711-1830

Mailing address

707 N Alvernon Way Ste 101
Tucson, AZ 85711-1830

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
I20240715001248 AZ Practitioner - Family Practice 9335543537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

707 N Alvernon Way
Suite 201
Tucson, AZ 85711-1847
Phone (520) 874-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R3576AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine Current Accepting new patients
Banner-University Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Banner - University Medical Center South Campus LLC Past Accepting new patients

Locations

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2800 E Ajo Way
Ste 121
Tucson, AZ 85713

2945 W Ina Rd
Ste 121
Tucson, AZ 85741
Phone (520) 694-7601

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

6860 E Sunrise Dr
Ste 100
Tucson, AZ 85750
Phone (520) 404-8710

707 N Alvernon Way
Ste 10
Tucson, AZ 85711

707 N Alvernon Way
Ste 101
Tucson, AZ 85711
Phone (520) 626-2551

707 N Alvernon Way
Ste 201
Tucson, AZ 85711
Phone (520) 694-1725

Organizations & group practices 4

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

Hospital & facility affiliations 4

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": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1053994525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N ALVERNON WAY STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N ALVERNON WAY STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111830",
            "telephone_number": "520-694-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLE",
        "first_name": "CARLI",
        "middle_name": "SHEA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R3576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.