Organization Active NPI

New Pueblo Medicine PC

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1295811495
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NEW PUEBLO MEDICINE PC
Practice address
6365 E Tanque Verde Rd 120
New Pueblo Medicine PC
Tucson, AZ 85715-3848
Phone
(520) 290-0300
Fax
(520) 298-9230
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Jeffrey I Selwyn, MD
Title
President
Phone
(520) 290-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X AZ Primary

Addresses

Primary practice location

6365 E Tanque Verde Rd 120
New Pueblo Medicine PC
Tucson, AZ 85715-3848

Mailing address

6365 E Tanque Verde Rd 120
New Pueblo Medicine PC
Tucson, AZ 85715-3848
Phone (520) 290-0300

Other identifiers 1

IdentifierTypeStateIssuer
CN8163OtherAZRR MEDICARE

Other names 1

  • Internal Medicine Associates Doing business as

National Provider Directory

National Provider Directory

Locations

6365 E Tanque Verde Rd
Ste 12
Tucson, AZ 85715
Phone (520) 290-0300

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1295811495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6365 E TANQUE VERDE RD 120",
            "address_2": "NEW PUEBLO MEDICINE PC",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153848",
            "telephone_number": "520-290-0300",
            "fax_number": "520-298-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6365 E TANQUE VERDE RD 120",
            "address_2": "NEW PUEBLO MEDICINE PC",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153848",
            "telephone_number": "520-290-0300",
            "fax_number": "520-298-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW PUEBLO MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "SELWYN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-290-0300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN8163",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.