Keith Ross Kaback, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

13902 Issued in AZ

Practice address

5301 E Grant Road
Tucson Medical Center Emergency Department
Tucson, AZ 85712-2805

Phone

(520) 324-1922

Fax

(520) 324-1088

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Swea, P.C.

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407953573
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154403186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 E PIMA STREET",
            "address_2": "SUITE B",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857125601",
            "telephone_number": "520-382-2819",
            "fax_number": "520-382-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT ROAD",
            "address_2": "TUCSON MEDICAL CENTER EMERGENCY DEPARTMENT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-324-1922",
            "fax_number": "520-324-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABACK",
        "first_name": "KEITH",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "13902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "240705",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240705-02",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• K & S MGT Inc
• Dipak Babu K C, MD
• K L Kennedy LLC
• K-Compassion LLC
• K.D. Keel PLLC
• Caroline M. Kacer, DMD
• Kurtis Andrew Kacer, D.M.D., M.S.
• Diana Kachan, MD, PHD
• Raymond L Kacich, M.D.
• Anya Lauren Kaczmarek, PA-C

• Emergency Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.