Individual provider Active NPI

Clayton Timothy Pierce

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1235691593
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R77617 Issued in AZ
Practice address
1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850
Phone
(602) 839-4567
Fax
(602) 839-2067
NPI assigned
Apr 4, 2019
Last updated
Jun 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R77617 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850

Mailing address

1300 N 12TH St Ste 605
Phoenix, AZ 85006-2850
Phone (602) 839-4567

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
I20230119001978 AZ Practitioner - Osteopathic Manipulative Medicine 6406182807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
University of Miami, LM Miller School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tucson Physician Group Holdings LLCGroup PAC ID 0547560070, 200 clinicians

Practice addresses (Care Compare)

4892 N Stone Ave
Suite 100
Tucson, AZ 85704-5761
Phone (520) 396-1360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.74 of 100Reported as group
Quality
79.16
Promoting interoperability
100
Improvement activities
40
Cost
69.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R77617AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Physician Group Holdings, LLC CurrentSince Oct 31, 2022 Accepting new patients
Carondelet Medical Group, Inc Family Medicine Past Accepting new patients

Locations

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

395 N Silverbell Rd
Ste 355
Tucson, AZ 85745
Phone (520) 622-5912

4790 S Calle Santa Cruz
Tucson, AZ 85714
Phone (520) 777-2277

4892 N Stone Ave
Ste 100
Tucson, AZ 85704
Phone (520) 396-1360

551 W Magee Rd
Tucson, AZ 85704
Phone (520) 498-6467

630 N Alvernon Way
Ste 251
Tucson, AZ 85711
Phone (520) 322-8460

6565 E Carondelet Dr
Ste 155
Tucson, AZ 85710
Phone (520) 849-8900

Interoperability endpoints

  • Direct secure messaging: clayton.pierce.1@600.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/MmWbh382tKlbvAIA1_DeLlIjYVSwroch/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1235691593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 605",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062850",
            "telephone_number": "602-839-4567",
            "fax_number": "602-839-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 605",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062850",
            "telephone_number": "602-839-4567",
            "fax_number": "602-839-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "CLAYTON",
        "middle_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R77617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.