Individual provider Active NPI

Megan Danielle Potilechio, DO

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tucson, AZ
National Provider Identifier
1255868451
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
R3459 Issued in AZ
Practice address
5301 E Grant Rd
Tucson, AZ 85712-2805
Phone
(520) 324-2308
Fax
(520) 324-1406
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X R3459 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X 5151011188 MI

Addresses

Primary practice location

5301 E Grant Rd
Tucson, AZ 85712-2805

Mailing address

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 324-2308

Other practice location 1

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

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
I20210721002614 AZ Practitioner - Hospice/Palliative Care 7315215134 Reassigns benefits to 1 organization
I20211110000051 TX Practitioner - Family Practice 7315215134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 324-4230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151011188MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Oct 4, 2021 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Oct 4, 2021 Accepting new patients
Dilkon Medical Center Current Accepting new patients
TMC Medical Network CurrentSince Apr 1, 2023 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

500 Indiana Ave
Winslow, AZ 86047

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1255868451",
    "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": "520-324-2308",
            "fax_number": "520-324-1406"
        },
        {
            "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": "520-324-2308",
            "fax_number": "520-324-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595452",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTILECHIO",
        "first_name": "MEGAN",
        "middle_name": "DANIELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "AZ",
            "license": "R3459",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151011188",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.