Individual provider Active NPI

Peter P Michalak, MD

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1104321777
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64431 Issued in AZ
Practice address
1631 W Ina Rd
Tucson, AZ 85704-1985
Phone
(520) 585-5738
Fax
(520) 585-5843
NPI assigned
Mar 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 64431 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1631 W Ina Rd
Tucson, AZ 85704-1985

Mailing address

4801 E Broadway Blvd Ste 251
Tucson, AZ 85711-2700
Phone (520) 327-0460

Other identifiers 1

IdentifierTypeStateIssuer
64431OtherAZAZ LICENSE

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
I20211216000936 AZ Practitioner - Family Practice 9537417464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Community Physicians PCGroup PAC ID 4587560552, 162 clinicians

Practice addresses (Care Compare)

2055 W Hospital Dr
Tucson, AZ 85704-7892
Phone (520) 547-5725

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physician PC CurrentSince Jan 1, 2022 Accepting new patients
Arizona Community Physicians PC Family Medicine Current Accepting new patients

Locations

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

1631 W Ina Rd
Tucson, AZ 85704
Phone (520) 585-5738

5055 E Broadway Blvd
Ste 100
Tucson, AZ 85711

Interoperability endpoints

  • Direct secure messaging: pmichalak19575@azacp.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1104321777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 E BROADWAY BLVD STE 251",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112700",
            "telephone_number": "520-327-0460",
            "fax_number": "520-795-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 W INA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041985",
            "telephone_number": "520-585-5738",
            "fax_number": "520-585-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALAK",
        "first_name": "PETER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "64431",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "64431",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.