Individual provider Active NPI

John R Bean, MD

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1063497105
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
11204 Issued in AZ
Practice address
3043 West Ina Rd.
Suite 115
Tucson, AZ 85741
Phone
(520) 797-7070
Fax
(520) 797-7077
NPI assigned
Dec 13, 2005
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 11204 AZ Primary

Addresses

Primary practice location

3043 West Ina Rd.
Suite 115
Tucson, AZ 85741

Mailing address

7320 N la Cholla Blvd
154-501
Tucson, AZ 85741-2309
Phone (520) 797-7070

Other identifiers 1

IdentifierTypeStateIssuer
203068MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physicians PC Family Medicine Past Accepting new patients
Northland Hearing Centers, Inc. PastSince Nov 1, 2010 Accepting new patients
Old Pueblo Pediatrics Past Accepting new patients
Arizona Community Physicians, PC Past Accepting new patients
Emergency Room Associates Limited Past Accepting new patients
Arizona Community Physician PC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1063497105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 N LA CHOLLA BLVD",
            "address_2": "154-501",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412309",
            "telephone_number": "520-797-7070",
            "fax_number": "520-797-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 WEST INA RD.",
            "address_2": "SUITE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85741",
            "telephone_number": "520-797-7070",
            "fax_number": "520-797-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "11204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203068",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.