NPIMap

Organization Active NPI

Mesa Verde Medical Group PC

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1265637888
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MESA VERDE MEDICAL GROUP PC
Practice address
395 N Silverbell Rd
Suite #265
Tucson, AZ 85745-2675
Phone
(520) 624-2194
Fax
(520) 624-2193
NPI assigned
Jun 15, 2007
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Dr. Armando Gonzalez, M.D.NPI 1003827692
Title
President
Phone
(520) 624-2194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Non-Pharmacy Dispensing Site 332900000X 24499 AZ

Addresses

Primary practice location

395 N Silverbell Rd
Suite #265
Tucson, AZ 85745-2675

Mailing address

PO Box 43160
Tucson, AZ 85733-3160
Phone (520) 624-2194

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1265637888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43160",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857333160",
            "telephone_number": "520-624-2194",
            "fax_number": "520-624-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N SILVERBELL RD",
            "address_2": "SUITE #265",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452675",
            "telephone_number": "520-624-2194",
            "fax_number": "520-624-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA VERDE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-624-2194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "AZ",
            "license": "24499",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Oct 14, 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.

Verify at the official NPI Registry.