Individual provider Active NPI

Tina Bach, MD

  • Internal Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1285642660
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24368 Issued in AZ
Practice address
8111 E Thomas Rd
Suite 124
Scottsdale, AZ 85251-5844
Phone
(602) 954-0444
Fax
(602) 952-7146
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24368 AZ Primary

Addresses

Primary practice location

8111 E Thomas Rd
Suite 124
Scottsdale, AZ 85251-5844

Mailing address

2733 N Power Rd
Suite 102-417
Mesa, AZ 85215-1682
Phone (602) 954-0444

Other identifiers 1

IdentifierTypeStateIssuer
361519OtherAZAHCCCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040131000077 AZ Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 1759284268 Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24368AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Anesthesia Partners, LLC PastSince Jun 28, 2020 Accepting new patients
Diamond Diagnostics, LLC PastSince Oct 13, 2012 Accepting new patients
Optum Palliative and Hospice Care, Inc. Past Accepting new patients
Diamond Medical Equipment L.L.C. Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1285642660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 N POWER RD",
            "address_2": "SUITE 102-417",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151682",
            "telephone_number": "602-954-0444",
            "fax_number": "602-952-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 E THOMAS RD",
            "address_2": "SUITE 124",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515844",
            "telephone_number": "602-954-0444",
            "fax_number": "602-952-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "24368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "361519",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.