Individual provider Active NPI

Ravitharan Krishnadasan, M.D.

  • Hematology & Oncology Physician
  • Tucson, AZ
National Provider Identifier
1174538995
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
12173 Issued in RI
Practice address
3838 N Campbell Ave
Tucson, AZ 85719-1478
Phone
(520) 694-2873
Fax
(520) 694-1820
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 12173 RI Primary

Addresses

Primary practice location

3838 N Campbell Ave
Tucson, AZ 85719-1478

Mailing address

2701 E Elvira Rd
Tucson, AZ 85756-7124
Phone (520) 874-3500

Other identifiers 2

IdentifierTypeStateIssuer
RK68305MedicaidRI
380225MedicaidAZ

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
I20090105000276 AZ Practitioner - Hematology/Oncology 0648379222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

2800 E Ajo Way
Tucson, AZ 85713-6204

3838 N Campbell Ave
Tucson, AZ 85719-1454

535 N Wilmot Rd
Suite 101
Tucson, AZ 85711-2683
Phone (520) 694-5437

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12173RIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jan 19, 2009 Accepting new patients
Banner-University Medical Group CurrentSince Jan 19, 2009 Accepting new patients

Locations

3838 N Campbell Ave
Tucson, AZ 85719
Phone (520) 694-2873

707 N Alvernon Way
Tucson, AZ 85711
Phone (520) 621-6323

1501 N Campbell Ave
#245575
Tucson, AZ 85724

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

2701 E Elvira Rd
Tucson, AZ 85756
Phone (520) 874-4024

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

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 2

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1174538995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857567124",
            "telephone_number": "520-874-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191478",
            "telephone_number": "520-694-2873",
            "fax_number": "520-694-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNADASAN",
        "first_name": "RAVITHARAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "RI",
            "license": "12173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RK68305",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380225",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.