Individual provider Active NPI

Eileen Mary Mahony, FNP

  • Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1104981752
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN056972 Issued in AZ
Practice address
140 W Speedway
Suite 100 St Elizabeth of Hungary Clinic
Tucson, AZ 85705-7698
Phone
(520) 628-7871
Fax
(520) 205-8461
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN056972 AZ Primary

Addresses

Primary practice location

140 W Speedway
Suite 100 St Elizabeth of Hungary Clinic
Tucson, AZ 85705-7698

Mailing address

140 W Speedway Blvd
Ste 100
Tucson, AZ 85705-7687
Phone (520) 628-7871

Other identifiers 3

IdentifierTypeStateIssuer
447624OtherAZPIMA HEALTH SYSTEMS
447624MedicaidAZ
447624001OtherAZMERCY CARE PLAN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051018000267 AZ Practitioner - Nurse Practitioner 8426074642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN056972AZMDNurse Practitioner
AP0222AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeths Health Center Inc CurrentSince Oct 1, 2014 Accepting new patients
Catholic Community Services of Southern Arizona, Inc. Current Accepting new patients
St Elizabeths Health Center Inc CurrentSince Oct 1, 2014 Accepting new patients

Locations

140 W Speedway Blvd
Ste 100
Tucson, AZ 85705
Phone (520) 628-7871

140 W Speedway Blvd
Ste 230
Tucson, AZ 85705

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1104981752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W SPEEDWAY BLVD",
            "address_2": "STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857057687",
            "telephone_number": "520-628-7871",
            "fax_number": "520-205-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W SPEEDWAY",
            "address_2": "SUITE 100 ST ELIZABETH OF HUNGARY CLINIC",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857057698",
            "telephone_number": "520-628-7871",
            "fax_number": "520-205-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONY",
        "first_name": "EILEEN",
        "middle_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN056972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIMA HEALTH SYSTEMS",
            "identifier": "447624",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447624",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE PLAN",
            "identifier": "447624001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.