Individual provider Active NPI

Mahesh Tipirneni, MD

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1285746230
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34480 Issued in AZ
Practice address
3601 S 6TH Ave
(1-11C3) Sag
Tucson, AZ 85723-0001
Phone
(520) 792-1450
Fax
(520) 629-1734
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34480 AZ
Internal Medicine Physician 207R00000X 36112232 IL
Internal Medicine Physician 207R00000X A93380 CA
Internal Medicine Physician 207R00000X M4592 TX
Emergency Medicine Physician 207P00000X 34480 AZ Primary

Addresses

Primary practice location

3601 S 6TH Ave
(1-11C3) Sag
Tucson, AZ 85723-0001

Mailing address

12293 N Durham Wash Dr
Marana, AZ 85658-4669

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
I20090827000142 AZ Practitioner - Internal Medicine 8628123643 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93380CAMDInternal Medicine Physician
36112232ILMDInternal Medicine Physician
M4592TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Allied Physicians LLC Internal Medicine CurrentSince Jun 21, 2009 Accepting new patients
Northwest Allied Physicians, LLC CurrentSince Jun 21, 2009 Accepting new patients
Vitality Medical Group, PLLC PastSince Sep 9, 2009 Accepting new patients

Locations

1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1285746230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12293 N DURHAM WASH DR",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856584669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE",
            "address_2": "(1-11C3) SAG",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857230001",
            "telephone_number": "520-792-1450",
            "fax_number": "520-629-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPIRNENI",
        "first_name": "MAHESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "34480",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36112232",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93380",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M4592",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "34480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.