NPIMap

Organization Active NPI

Pascua Yaqui Tribe

  • Community/Behavioral Health Agency
  • Tucson, AZ
National Provider Identifier
1194230672
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC8558 Issued in AZ
Legal business name
PASCUA YAQUI TRIBE
Practice address
1775 W Saint Marys Rd Ste 115
Tucson, AZ 85745-2655
Phone
(520) 879-5450
Fax
(520) 207-6409
NPI assigned
Dec 6, 2017
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PASCUA YAQUI TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Linda Guerrero
Title
Delegated Official
Phone
(520) 879-6039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC8558 AZ Primary

Addresses

Primary practice location

1775 W Saint Marys Rd Ste 115
Tucson, AZ 85745-2655

Mailing address

7490 S. Camino de Oeste
Tucson, AZ 85757
Phone (520) 879-6107

Other identifiers 1

IdentifierTypeStateIssuer
380226MedicaidAZ

Other names 1

  • CSP St. Mary's Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220120000627 TX Part B Supplier - Clinic/Group Practice 7618033598 Receives reassigned benefits from 31 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ; Guadalupe, AZ

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Pascua Yaqui Tribe21 organizations share this tax ID, including this one
Part of
Pascua Yaqui Tribe

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

1701 W Saint Marys Rd
Ste 120
Tucson, AZ 85745
Phone (520) 624-3999

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1194230672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7490 S. CAMINO DE OESTE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85757",
            "telephone_number": "520-879-6107",
            "fax_number": "520-879-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W SAINT MARYS RD STE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452655",
            "telephone_number": "520-879-5450",
            "fax_number": "520-207-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASCUA YAQUI TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PASCUA YAQUI TRIBE",
        "enumeration_date": "2017-12-06",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "GUERRERO",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "520-879-6039"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC8558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380226",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSP St. Mary's",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.