Ellen Marie San Buenaventura, MD

Primary specialty

Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X

License

14454 Issued in AZ

Practice address

5161 N Stonehouse PL
Tucson, AZ 85750-9671

Phone

(520) 749-5889

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• American Current Care of Arizona PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1780873307
  Medicare reassignment
• Carondelet Health Network

  dba Bridges Geropsychiatric Program at St. Mary's Hospital

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1750788667
  NPD (past)
• Emergency Room Associates Limited

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1770586869
  NPD (past)
• Swea, P.C.

  dba Southwest Emergency Associates, P.C.

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407953573
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1083796098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5161 N STONE HOUSE PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85750",
            "telephone_number": "520-749-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5161 N STONEHOUSE PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857509671",
            "telephone_number": "520-749-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN BUENAVENTURA",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "14454",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "14454",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "240119",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240119-10",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "370016065",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samu International
• Gail-Ann Mahaila Samuel, NP
• Cheryl Samuels, FNP-C
• Lynn Ellen Samuels, M.D.
• Robert Samuelson, MD
• Janet San Nicholas
• San Rafael Hearing Center (Riley Barney)
• San Rafael Hearing Center, LLC
• San Xavier District Office
• Bekir Sanal

• Pediatric Emergency Medicine (Emergency Medicine) Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pediatric Emergency Medicine (Emergency Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.