Active NPI
Vicki Kalen, MD
- Pediatric Surgery Physician
- Tucson, AZ
National Provider Identifier
1073588547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 34452
- Practice address
- 3402 E Broadway Blvd
Tucson, AZ 85716-5406 - Phone
- (520) 881-0050
- NPI assigned
- Feb 20, 2006
- Last updated
- Mar 13, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 34452 | AZ | Primary |
Addresses
Primary practice location
3402 E Broadway Blvd
Tucson, AZ 85716-5406
Mailing address
3402 E Broadway Blvd
Tucson, AZ 85716-5406
Phone (520) 881-0050
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447448923 | Other | AZ | GROUP NPI |
| 1033307715 | Other | AZ | GROUP NPI |
| 1750579439 | Other | AZ | GROUP NPI |
| 1396933974 | Other | AZ | GROUP NPI |
| 1780873307 | Other | AZ | GROUP NPI |
| 1871782490 | Other | AZ | GROUP NPI |
| Z126048 | Other | AZ | GROUP PTAN |
| 1033398201 | Other | AZ | GROUP NPI |
| 1457543324 | Other | AZ | GROUP NPI |
| 1740479518 | Other | AZ | GROUP NPI |
| 1831387315 | Other | AZ | GROUP NPI |
| Z120952 | Other | GROUP PTAN | |
| Z126262 | Other | AZ | MEDICARE PTAN |
| 1376731851 | Other | AZ | GROUP NPI |
| Z126263 | Other | AZ | MEDICARE PTAN |
| 1588843734 | Other | AZ | GROUP NPI |
| 1770771255 | Other | AZ | GROUP NPI |
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 |
|---|---|---|---|
| 34452 | AZ | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner-University Medical Group | Family Medicine | Past | Accepting new patients |
| Tri-City Express Care, PLLC | Family Medicine | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1508809427
Family Medicine
-
dba FastMed Urgent Care
- Family Medicine Physician
- Mesa, AZ
- NPI 1649554940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236902400000",
"number": "1073588547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3402 E BROADWAY BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857165406",
"telephone_number": "520-881-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3402 E BROADWAY BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857165406",
"telephone_number": "520-881-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALEN",
"first_name": "VICKI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-20",
"last_updated": "2009-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "AZ",
"license": "34452",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1447448923",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1033307715",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1750579439",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1396933974",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1780873307",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1871782490",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "Z126048",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1033398201",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1457543324",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1740479518",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1831387315",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "Z120952",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "Z126262",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1376731851",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "Z126263",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1588843734",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1770771255",
"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 Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.