Individual provider Active NPI

Nicolas Enriquez, M.D.

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1255786455
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R75455 Issued in AZ
Practice address
6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone
(520) 229-2657
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R75455 AZ Primary

Addresses

Primary practice location

6200 N la Cholla Blvd
Tucson, AZ 85741-3529

Mailing address

6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone (520) 229-2657

Other identifiers 1

IdentifierTypeStateIssuer
476728MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190315000881 AZ Practitioner - Emergency Medicine 9234489295 Reassigns benefits to 3 organizations
I20190826000656 TX Practitioner - Emergency Medicine 9234489295 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Drexel University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chandler Emergency Medical Group LLCGroup PAC ID 1658272968, 47 clinicians
Dhew Ind HLTH SV HLTH SVS and MNTL HLTH AdmGroup PAC ID 1759290901, 219 clinicians
Gila River Health Care CorporationGroup PAC ID 0648174185, 245 clinicians

Practice addresses (Care Compare)

1955 W Frye Rd
Chandler, AZ 85224-6282
Phone (954) 939-5000

4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

483 W Seed Farm Rd
Hu Hu Kam Memorial Hospital
Sacaton, AZ 85147-0038
Phone (602) 528-7100

Hospital & facility affiliations

  • Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
  • Huhu Kam Memorial Hospital Hospital, Sacaton, AZ, CCN 031308
  • Phoenix Indian Medical Center Hospital, Phoenix, AZ, CCN 030078

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R75455AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Regional Behavioral Health Authority CurrentSince Aug 8, 2024 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Apr 18, 2024 Accepting new patients
Northwest HBP Medical Services LLC Emergency Medicine CurrentSince Dec 15, 2018 Accepting new patients
Gila River Health Care CurrentSince Aug 8, 2024 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Jul 18, 2019 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Apr 18, 2024 Accepting new patients
Progressive Medical Associates PLLC Emergency Medicine CurrentSince Mar 25, 2021 Accepting new patients
Chandler Emergency Medical Group, LLC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1255786455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413529",
            "telephone_number": "520-229-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413529",
            "telephone_number": "520-229-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "NICOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R75455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "476728",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.