Individual provider Active NPI

Donald Eric Tutt, MD

  • Obstetrics & Gynecology Physician
  • Mesa, AZ
National Provider Identifier
1265453450
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
16197 Issued in AZ
Practice address
4824 E Baseline Rd
Ste 129
Mesa, AZ 85206-4679
Phone
(480) 644-1001
Fax
(480) 644-1002
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 16197 AZ Primary

Addresses

Primary practice location

4824 E Baseline Rd
Ste 129
Mesa, AZ 85206-4679

Mailing address

4824 E Baseline Rd
Ste 129
Mesa, AZ 85206-4679
Phone (480) 644-1001

Other identifiers 1

IdentifierTypeStateIssuer
272782MedicaidAZ

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
I20040909000778 AZ Practitioner - Obstetrics/Gynecology 9133195233 Practice locations: Mesa, AZ

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Women's Health Partners PLLC Obstetrics & Gynecology Current Accepting new patients

Locations

4824 E Baseline Rd
Ste 129
Mesa, AZ 85206
Phone (480) 644-1001

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1265453450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064679",
            "telephone_number": "480-644-1001",
            "fax_number": "480-644-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064679",
            "telephone_number": "480-644-1001",
            "fax_number": "480-644-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTT",
        "first_name": "DONALD",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "16197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272782",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.