Individual provider Active NPI

Brandon Welker, D.O.

  • Diagnostic Radiology Physician
  • Tucson, AZ
National Provider Identifier
1104082668
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
05927 Issued in AZ
Practice address
2492 E River Rd
Tucson, AZ 85718-9552
Phone
(520) 335-6849
Fax
(520) 459-2191
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 05927 AZ Primary

Addresses

Primary practice location

2492 E River Rd
Tucson, AZ 85718-9552

Mailing address

2492 E River Rd
Tucson, AZ 85718-9552
Phone (520) 722-8994

Other identifiers 1

IdentifierTypeStateIssuer
758474MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121105000221 AZ Practitioner - Diagnostic Radiology 3274711262 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mt Graham Regional Medical Center IncGroup PAC ID 6204822364, 64 clinicians

Practice addresses (Care Compare)

1600 S 20TH Ave
Safford, AZ 85546-4011
Phone (928) 348-4000

Hospital & facility affiliations

  • Mt. Graham Regional Medical Center Hospital, Safford, AZ, CCN 031319

Merit-based Incentive Payment System (MIPS)

Final score
97.01 of 100Reported as group
Quality
95
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05927AZMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Graham Regional Medical Center Inc CurrentSince Jan 30, 2024 Accepting new patients
Arizona Oncology Associates PC Diagnostic Radiology CurrentSince May 31, 2022 Accepting new patients
Arizona Blood and Cancer Specialists, PLLC CurrentSince Jan 10, 2021 Accepting new patients

Locations

1600 S 20th Ave
Safford, AZ 85546
Phone (928) 348-4000

2625 N Craycroft Rd
Ste 20
Tucson, AZ 85712
Phone (520) 324-2409

2951 N Swan Rd
Ste 155
Tucson, AZ 85712
Phone (520) 323-5900

2070 W Rudasill Rd
Ste 130
Tucson, AZ 85704
Phone (520) 420-2520

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

3945 E Paradise Falls Dr
Ste 201
Tucson, AZ 85712
Phone (520) 290-5888

2492 E River Rd
Tucson, AZ 85718
Phone (520) 335-6849

3945 E Paradise Falls Dr
Ste 105
Tucson, AZ 85712
Phone (520) 689-7022

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1104082668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857189552",
            "telephone_number": "520-722-8994",
            "fax_number": "520-624-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2492 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857189552",
            "telephone_number": "520-335-6849",
            "fax_number": "520-459-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELKER",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "05927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758474",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.