Organization Active NPI

Proactive Medical, PLLC

  • Family Medicine Physician
  • Oro Valley, AZ
National Provider Identifier
1285079772
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7460 Issued in AZ
Legal business name
PROACTIVE MEDICAL, PLLC
Practice address
10425 N Oracle Rd
Ste. 105
Oro Valley, AZ 85737-9357
Phone
(520) 544-7644
Fax
(520) 544-0548
NPI assigned
May 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Dr. Thomas F Griffin, MD
Title
President
Phone
(520) 544-7644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 7460 AZ Primary

Addresses

Primary practice location

10425 N Oracle Rd
Ste. 105
Oro Valley, AZ 85737-9357

Mailing address

PO Box 43160
Tucson, AZ 85733-3160
Phone (520) 722-3777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130807000921 AZ Part B Supplier - Clinic/Group Practice 5395987135 Receives reassigned benefits from 3 practitioners
Practice locations: Oro Valley, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2002575Proactive Medical, PLLC10425 N Oracle, Ste 105, Oro Valley, AZ 85737Provider-performed microscopyJan 19, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1285079772",
    "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": "520-722-3777",
            "fax_number": "520-296-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 N ORACLE RD",
            "address_2": "STE. 105",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857379357",
            "telephone_number": "520-544-7644",
            "fax_number": "520-544-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-544-7644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "7460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oro Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.