NPIMap

Organization Active NPI

Southern Arizona Internal Medicine PLLC

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1275565509
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12805 Issued in AZ
Legal business name
SOUTHERN ARIZONA INTERNAL MEDICINE PLLC
Practice address
5210 E Farness Dr
Tucson, AZ 85712-2140
Phone
(520) 795-4100
Fax
(520) 795-4224
NPI assigned
Jul 7, 2006
Last updated
Aug 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Authorized official

Name
Steven A Wool, MDNPI 1780789800
Title
President
Phone
(520) 795-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12805 AZ Primary

Addresses

Primary practice location

5210 E Farness Dr
Tucson, AZ 85712-2140

Mailing address

5210 E Farness Dr
Tucson, AZ 85712-2140
Phone (520) 795-4100

Other identifiers 1

IdentifierTypeStateIssuer
869365MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824001341 AZ Part B Supplier - Clinic/Group Practice 6002880044 Receives reassigned benefits from 10 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory
Tax ID family
Southern Arizona Internal Med2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1275565509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 E FARNESS DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122140",
            "telephone_number": "520-795-4100",
            "fax_number": "520-795-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 E FARNESS DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122140",
            "telephone_number": "520-795-4100",
            "fax_number": "520-795-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ARIZONA INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "WOOL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-795-4100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "12805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "869365",
            "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 Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.