Individual provider Active NPI

Randa M Kutob, MD

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1326145889
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22832 Issued in AZ
Practice address
707 N Alvernon Way Ste 101
Tucson, AZ 85711-1830
Phone
(520) 694-8888
Fax
(520) 694-1640
NPI assigned
Sep 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22832 AZ Primary

Addresses

Primary practice location

707 N Alvernon Way Ste 101
Tucson, AZ 85711-1830

Mailing address

2701 E Elvira Rd
Tucson, AZ 85706-7124
Phone (520) 874-3500

Other identifiers 1

IdentifierTypeStateIssuer
201667MedicaidAZ

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
I20100526000498 AZ Practitioner - Family Practice 2567591720 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

2800 E Ajo Way
Tucson, AZ 85713-6204

707 N Alvernon Way
Tucson, AZ 85711-1847

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jan 1, 1992 Accepting new patients
B--Umg Integrated Health Clinic, LLC CurrentSince Jul 26, 2017 Accepting new patients
Banner-University Medical Group CurrentSince Jan 1, 1992 Accepting new patients

Locations

707 N Alvernon Way
Ste 201
Tucson, AZ 85711
Phone (520) 694-1725

535 N Wilmot Rd
Fl 2
Tucson, AZ 85711
Phone (520) 694-1234

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

707 N Alvernon Way
Ste 101
Tucson, AZ 85711
Phone (520) 626-2551

2701 E Elvira Rd
Tucson, AZ 85756
Phone (520) 874-4024

3950 S Country Club Rd
Ste 200
Tucson, AZ 85714
Phone (520) 626-5582

3950 S Country Club Rd
Ste 140
Tucson, AZ 85714
Phone (520) 626-1609

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1326145889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857067124",
            "telephone_number": "520-874-3500",
            "fax_number": "520-874-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N ALVERNON WAY STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111830",
            "telephone_number": "520-694-8888",
            "fax_number": "520-694-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTOB",
        "first_name": "RANDA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "22832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201667",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.