Individual provider Active NPI

Matthew Dinovitz

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1265896005
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R75442 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone
(520) 626-6255
NPI assigned
Apr 7, 2016
Last updated
Apr 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R75442 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-0001

Mailing address

1501 N Campbell Ave
Tucson, AZ 85724-0001

Other identifiers 1

IdentifierTypeStateIssuer
R75442MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201208002283 CA Practitioner - Psychiatry 2961793013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Geisel School of Medicine at Dartmouth, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9015 Murray Ave
Suite 100
Gilroy, CA 95020-3675
Phone (408) 842-7138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
69169MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Solutions for Children, Families and Individuals CurrentSince Oct 12, 2020 Accepting new patients
Community Solutions for Children, Families, and Individuals CurrentSince Oct 12, 2020 Accepting new patients
Community Solutions for Children, Families and Individuals Current Accepting new patients

Locations

9015 Murray Ave
Ste 100
Gilroy, CA 95020
Phone (408) 665-4908

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1265896005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001",
            "telephone_number": "520-626-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINOVITZ",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "R75442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R75442",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.