Active NPI
Jason Theodosakis, M.D.
- Public Health & General Preventive Medicine Physician
- Tucson, AZ
National Provider Identifier
1285041822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 19640
- Practice address
- 5257 N Via Sempreverde
Tucson, AZ 85750-5967 - Phone
- (520) 577-9550
- NPI assigned
- Jul 15, 2014
- 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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 19640 | AZ | Primary |
Addresses
Primary practice location
5257 N Via Sempreverde
Tucson, AZ 85750-5967
Mailing address
5257 N Via Sempreverde
Tucson, AZ 85750-5967
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19640 | AZ | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1285041822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5257 N VIA SEMPREVERDE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857505967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5257 N VIA SEMPREVERDE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857505967",
"telephone_number": "520-577-9550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEODOSAKIS",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-15",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "AZ",
"license": "19640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
- Tatum Thelander
- Charlene Thelemaque
- Thelighthouse Residential LLC
- Andreas A Theodorou, M.D.
- Maria S Theodorou, MD
- Therapeutic Ranch for Animaks and Kids (Trak)
- Therapeutic Riding of Tucson (TROT Therapy Services)
- Therapy Group of Tucson, LLC (Odyssey Autism ABA Therapy)
- Theratrics, Inc. (Theratrics)
- Nicole Andrea Thexton, CRT, RRT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.