Active NPI
Richard Mark Blew, M.D.
- Orthopaedic Surgery Physician
- Tucson, AZ
National Provider Identifier
1073576856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 11757
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 224551-01 | Medicaid | AZ |
Other names 1
- Dr. R. Mark Blew
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11757 | AZ | MD | Orthopaedic Foot and Ankle Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Community Surgeons PC | Orthopaedic Surgery | Past | 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.
-
- Otolaryngology Physician
- Scottsdale, AZ
- NPI 1508990185
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.