Active NPI
David S Nathalang, D.O.
- Pediatric Critical Care Medicine Physician
- Tucson, AZ
National Provider Identifier
1174847255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 005447
- Practice address
- 1501 N Campbell Avenue
Tucson, AZ 85724 - Phone
- (520) 626-5485
- Fax
- (520) 626-6571
- NPI assigned
- Mar 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 20A9613 | CA | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 005447 | AZ | Primary |
Addresses
Primary practice location
1501 N Campbell Avenue
Tucson, AZ 85724
Mailing address
2701 E Elvira Rd
Tucson, AZ 85756-7124
Phone (520) 626-5485
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A9613 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner-University Medical Group | Family Medicine | Current | Accepting new patients |
| Banner-University Medical Group | Current | Accepting new patients | |
| Banner - University Medical Center Tucson Campus LLC | Past | Accepting new patients |
Locations
2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471
1625 N Campbell Ave
Tucson, AZ 85719
1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747
2701 E Elvira Rd
Tucson, AZ 85756
Phone (520) 874-4024
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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1508809427
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Tucson, AZ
- NPI 1922820935
-
- General Acute Care Hospital
- Tucson, AZ
- NPI 1265820179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1174847255",
"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": "520-626-5485",
"fax_number": "520-626-6571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 N CAMPBELL AVENUE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85724",
"telephone_number": "520-626-5485",
"fax_number": "520-626-6571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATHALANG",
"first_name": "DAVID",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-18",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "CA",
"license": "20A9613",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "AZ",
"license": "005447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.