Individual provider Active NPI

Richard Mark Blew, M.D.

  • Orthopaedic Surgery Physician
  • Tucson, AZ
National Provider Identifier
1073576856
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
11757 Issued in AZ
Practice address
6567 E Carondelet Dr
Suite 415
Tucson, AZ 85710-2156
Phone
(520) 885-6701
Fax
(520) 885-9037
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 11757 AZ Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 11757 AZ
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 11757 AZ
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 11757 AZ

Addresses

Primary practice location

6567 E Carondelet Dr
Suite 415
Tucson, AZ 85710-2156

Mailing address

6567 E Carondelet Dr
Suite 415
Tucson, AZ 85710-2119
Phone (520) 885-6701

Other identifiers 1

IdentifierTypeStateIssuer
224551-01MedicaidAZ

Other names 1

  • Dr. R. Mark Blew Other name

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

State licenses

LicenseStateTypeSpecialty
11757AZMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Surgeons PC Orthopaedic Surgery PastSince Aug 1, 2006 Accepting new patients
Valley ENT, PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1073576856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6567 E CARONDELET DR",
            "address_2": "SUITE 415",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102119",
            "telephone_number": "520-885-6701",
            "fax_number": "520-885-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6567 E CARONDELET DR",
            "address_2": "SUITE 415",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102156",
            "telephone_number": "520-885-6701",
            "fax_number": "520-885-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEW",
        "first_name": "RICHARD",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "11757",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "AZ",
            "license": "11757",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "AZ",
            "license": "11757",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "11757",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224551-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "BLEW",
            "middle_name": "MARK",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 11, 2010; 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.