Active NPI
Reza Vafaie
- Respite Care
- Tucson, AZ
National Provider Identifier
1265067102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- License
- BH6014
- Practice address
- 1070 W Sea Lion Dr
Tucson, AZ 85704-2542 - Phone
- (520) 971-5229
- NPI assigned
- Mar 11, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | BH6014 | AZ | Primary |
Addresses
Primary practice location
1070 W Sea Lion Dr
Tucson, AZ 85704-2542
Mailing address
1070 W Sea Lion Dr
Tucson, AZ 85704-2542
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH6014 | Other | AZ | AZ DEPT OF HEALTH SERVICES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH6014 | AZ | MD | Respite Care |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thelighthouse Residential LLC | Current | Accepting new patients | |
| The Devereux Foundation | Past | Accepting new patients |
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Tucson, AZ
- NPI 1023850948
-
- Adolescent and Children Mental Health Clinic/Center
- Phoenix, AZ
- NPI 1306939368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609113600000",
"number": "1265067102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 W SEA LION DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857042542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 W SEA LION DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857042542",
"telephone_number": "520-971-5229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAFAIE",
"first_name": "REZA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-11",
"last_updated": "2020-12-28",
"certification_date": "2020-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "AZ",
"license": "BH6014",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ DEPT OF HEALTH SERVICES",
"identifier": "BH6014",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}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 Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.