Individual provider Active NPI

Kathryn R Sanderlin, MD

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1336219724
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
31173 Issued in AZ
Practice address
2800 E Ajo Way
Tucson, AZ 85713-6204
Phone
(520) 626-7664
Fax
(520) 874-4016
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 31173 AZ Primary

Addresses

Primary practice location

2800 E Ajo Way
Tucson, AZ 85713-6204

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
838328MedicaidAZ

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
I20051031000743 AZ Practitioner - Psychiatry 5597782334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arizona College of Medicine, 2001
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

Hospital & facility affiliations

  • Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111
  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011

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

State licenses

LicenseStateTypeSpecialty
31173AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Mar 13, 2007 Accepting new patients
Banner-University Medical Group CurrentSince Mar 13, 2007 Accepting new patients
Connections Southernaz, LLC Outpatient CurrentSince Dec 1, 2014 Accepting new patients
University Physicians Healthcare Psychiatry Past Accepting new patients

Locations

2800 E Ajo Way
Ste P1241
Tucson, AZ 85713

1501 N Campbell Ave
#245575
Tucson, AZ 85724

2802 E District St
Tucson, AZ 85714
Phone (520) 622-6000

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

2802 E District St
Fl 2
Tucson, AZ 85714
Phone (602) 253-5100

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

2802 E District St
Fl 1
Tucson, AZ 85714
Phone (602) 253-5100

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

1625 N Campbell Ave
Tucson, AZ 85719

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.

Hospital & facility affiliations 3

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1336219724",
    "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": "520-874-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-626-7664",
            "fax_number": "520-874-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERLIN",
        "first_name": "KATHRYN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "31173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838328",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.