Individual provider Active NPI

Trevor Thomas Thiss, DO

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1356039192
Registry record updated Aug 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R4064 Issued in AZ
Practice address
3950 S Country Club Rd Ste 200
Tucson, AZ 85714-2227
Phone
(520) 626-5582
NPI assigned
Apr 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R4064 AZ Primary

Addresses

Primary practice location

3950 S Country Club Rd Ste 200
Tucson, AZ 85714-2227

Mailing address

3950 S Country Club Rd Ste 200
Tucson, AZ 85714-2227

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
I20230802002810 AZ Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 4385005644

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691884800000",
    "number": "1356039192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD STE 200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD STE 200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142227",
            "telephone_number": "520-626-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THISS",
        "first_name": "TREVOR",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-08-13",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R4064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.