Individual provider Active NPI

Mark A Zaetta, MD

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1114901394
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25691 Issued in AZ
Practice address
4730 E Grant Rd
Tucson, AZ 85712-2703
Phone
(520) 290-0300
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25691 AZ Primary

Addresses

Primary practice location

4730 E Grant Rd
Tucson, AZ 85712-2703

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (520) 290-0300

Other identifiers 6

IdentifierTypeStateIssuer
10093OtherPACFICARE SECURE HORIZONS
110159569OtherRR MEDICARE
860780125OtherCIGNA
1763237OtherUNITED HEALTH CARE
1Z7531OtherHEALTH NET
AZ0811130OtherBLUE CROSS BLUE SHIELD

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
I20100504000294 AZ Practitioner - Internal Medicine 7315075819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

7510 N Oracle Rd
Suite 100
Tucson, AZ 85704-4447
Phone (520) 324-4230

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Tucson, AZ, CCN 037213
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25691AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Apr 1, 2016 Accepting new patients
TMC Medical Network CurrentSince Aug 1, 2025 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Apr 1, 2016 Accepting new patients

Locations

695 S Pecan Tree Ln
Green Valley, AZ 85614
Phone (520) 625-8116

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

1845 W Orange Grove Rd
Ste 115
Tucson, AZ 85704
Phone (520) 290-0300

3476 S Kino Pkwy
Tucson, AZ 85713
Phone (520) 420-2340

7510 N Oracle Rd
Ste 100
Tucson, AZ 85704
Phone (520) 324-4230

6365 E Tanque Verde Rd
Ste 12
Tucson, AZ 85715
Phone (520) 290-0300

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

6365 E Tanque Verde Rd
Ste 120
Tucson, AZ 85715
Phone (520) 290-0300

4730 E Grant Rd
Tucson, AZ 85712
Phone (520) 290-0300

Interoperability endpoints

  • Direct secure messaging: mark.zaetta.1@17260.direct.athenahealth.com

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.

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1114901394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "520-290-0300",
            "fax_number": "520-298-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122703",
            "telephone_number": "520-290-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAETTA",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "25691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACFICARE SECURE HORIZONS",
            "identifier": "10093",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110159569",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "860780125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1763237",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "1Z7531",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0811130",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.