Individual provider Active NPI

Michele Peri Gersman, CNM

  • Advanced Practice Midwife
  • Tucson, AZ
National Provider Identifier
1184977217
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
264589 Issued in AZ
Practice address
5301 E Grant Rd
Tucson, AZ 85712-2805
Phone
(520) 795-8188
NPI assigned
Oct 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 643499-1 NY
Advanced Practice Midwife 367A00000X CNM1154 NY
Advanced Practice Midwife 367A00000X 264589 AZ Primary

Addresses

Primary practice location

5301 E Grant Rd
Tucson, AZ 85712-2805

Mailing address

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 795-8188

Other identifiers 1

IdentifierTypeStateIssuer
103983MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123002134 AZ Practitioner - Certified Nurse Midwife (CNM) 2961633268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
643499-1NYMDRegistered Nurse
001594NYMDPhysician Assistant
264589AZMDAdvanced Practice Midwife
CNM1154NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Nov 18, 2021 Accepting new patients

Locations

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

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

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: mgersman844790@nychhc.direct-ci.com

Organizations & group practices 1

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": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1184977217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-795-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-795-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSMAN",
        "first_name": "MICHELE",
        "middle_name": "PERI",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "643499-1",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "CNM1154",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "264589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.