Individual provider Active NPI

Anthony Chavez, MD

  • Urology Physician
  • Tucson, AZ
National Provider Identifier
1104084029
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
43767 Issued in AZ
Practice address
5170 E Glenn St Ste 100
Tucson, AZ 85712-7301
Phone
(520) 355-5111
Fax
(520) 844-6901
NPI assigned
May 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 43767 AZ Primary

Addresses

Primary practice location

5170 E Glenn St Ste 100
Tucson, AZ 85712-7301

Mailing address

5170 E Glenn St Ste 100
Tucson, AZ 85712-7301
Phone (520) 355-5111

Other identifiers 1

IdentifierTypeStateIssuer
606467MedicaidAZ

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
I20110628000428 AZ Practitioner - Urology 2466630132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Arizona College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5170 E Glenn St
Suite 100
Tucson, AZ 85712-7301
Phone (520) 355-5111

Hospital & facility affiliations

  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43767AZMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Mountain Urology Urology CurrentSince Jul 16, 2014 Accepting new patients

Locations

5170 E Glenn St
Ste 100
Tucson, AZ 85712
Phone (520) 209-2500

5240 E Knight Dr
Ste 108
Tucson, AZ 85712
Phone (520) 321-4266

Organizations & group practices 1

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1104084029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 E GLENN ST STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857127301",
            "telephone_number": "520-355-5111",
            "fax_number": "520-844-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 E GLENN ST STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857127301",
            "telephone_number": "520-355-5111",
            "fax_number": "520-844-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "43767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606467",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.