Individual provider Active NPI

Stephanie Marie Ottusch

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1255943775
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
288359 Issued in AZ
Practice address
5555 E 5TH St Ste 101
Tucson, AZ 85711-2415
Phone
(520) 886-4181
Fax
(520) 721-7536
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 288359 AZ Primary
Registered Nurse 163W00000X 201141583RN OR

Addresses

Primary practice location

5555 E 5TH St Ste 101
Tucson, AZ 85711-2415

Mailing address

4801 E Broadway Blvd Ste 251
Tucson, AZ 85711-2700
Phone (520) 795-4783

Other practice location 1

2709 W Firebrook Rd
Tucson, AZ 85741-5224
Phone (541) 979-3089

Other identifiers 1

IdentifierTypeStateIssuer
201141583RNOtherOROREGON STATE BOARD OF NURSING

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230316000601 AZ Practitioner - Nurse Practitioner 1951775873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Arizona College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Community Physicians PCGroup PAC ID 4587560552, 162 clinicians

Practice addresses (Care Compare)

2055 W Hospital Dr
Tucson, AZ 85704-7892
Phone (520) 547-5725

5055 E Broadway Blvd
Suite A100
Tucson, AZ 85711-3629
Phone (520) 795-4783

5515 E 5TH St
Tucson, AZ 85711-2415
Phone (520) 298-1138

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201141583RNORMDRegistered Nurse
288359AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physician PC CurrentSince May 1, 2023 Accepting new patients
Arizona Community Physicians PC CurrentSince Nov 12, 2023 Accepting new patients

Locations

5555 E 5th St
Ste 101
Tucson, AZ 85711
Phone (520) 570-7884

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

Interoperability endpoints

  • Direct secure messaging: sottusch19566@azacp.direct-ci.com

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 and National Provider Directory roles.

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1255943775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 E BROADWAY BLVD STE 251",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112700",
            "telephone_number": "520-795-4783",
            "fax_number": "520-547-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E 5TH ST STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112415",
            "telephone_number": "520-886-4181",
            "fax_number": "520-721-7536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2709 W Firebrook Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857415224",
            "country_code": "US",
            "telephone_number": "541-979-3089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTUSCH",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "288359",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201141583RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BOARD OF NURSING",
            "identifier": "201141583RN",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.