Organization Active NPI

Christine Tymczyna DO PLLC

  • Family Medicine Physician
  • Tempe, AZ
National Provider Identifier
1104253004
Registry record updated Nov 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0055207 Issued in AZ
Legal business name
CHRISTINE TYMCZYNA DO PLLC
Practice address
4450 S Rural Rd Ste C230
Tempe, AZ 85282-7020
Phone
(602) 237-5088
Fax
(602) 900-9967
NPI assigned
Oct 9, 2013
Organization subpart
Yes
Parent organization
CHRISTINE TYMCZYNA DO PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2017

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

Authorized official

Name
Dr. Christine Tymczyna, DONPI 1104139591
Title
President
Phone
(602) 237-5088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0055207 AZ Primary

Addresses

Primary practice location

4450 S Rural Rd Ste C230
Tempe, AZ 85282-7020

Mailing address

4450 S Rural Rd Ste C230
Tempe, AZ 85282-7020
Phone (602) 237-5088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140212000250 AZ Part B Supplier - Clinic/Group Practice 3678702792 Receives reassigned benefits from 1 practitioner
Practice locations: Tempe, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2114034Christine Tymczyna, DO PLLC4450 S Rural Rd, BLDG C, Ste 230, Tempe, AZ 85282Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory
Part of
Christine Tymczyna DO PLLC

Locations

2152 S Vineyard
Ste 138
Mesa, AZ 85210
Phone (480) 539-6646

4450 S Rural Rd
Ste C230
Tempe, AZ 85282
Phone (602) 237-5088

4450 S Rural Rd
Ste 230
Tempe, AZ 85282
Phone (480) 418-6044

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511568000000",
    "number": "1104253004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 S RURAL RD STE C230",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827020",
            "telephone_number": "602-237-5088",
            "fax_number": "602-900-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 S RURAL RD STE C230",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827020",
            "telephone_number": "602-237-5088",
            "fax_number": "602-900-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE TYMCZYNA DO PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTINE TYMCZYNA DO PLLC",
        "enumeration_date": "2013-10-09",
        "last_updated": "2017-11-25",
        "status": "A",
        "authorized_official_last_name": "TYMCZYNA",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-237-5088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "0055207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.