Individual provider Active NPI

Randall P Mason, M.D.

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1366442014
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11045 Issued in AZ
Practice address
350 N Wilmot Rd
Carondelet St. Joseph'S Hospital Emergency Dept
Tucson, AZ 85711
Phone
(520) 873-5429
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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 11045 AZ Primary

Addresses

Primary practice location

350 N Wilmot Rd
Carondelet St. Joseph'S Hospital Emergency Dept
Tucson, AZ 85711

Mailing address

630 N Alvernon Way
Ste 250
Tucson, AZ 85711-1843
Phone (520) 647-8850

Other identifiers 1

IdentifierTypeStateIssuer
201658MedicaidAZ

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
I20100803000069 AZ Practitioner - Emergency Medicine 1557494291 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11045AZMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Arizona, Inc. Emergency Medicine CurrentSince Apr 12, 2017 Accepting new patients
Emergency Room Associates Past Accepting new patients
Banner-University Medical Group Emergency Medicine Past Accepting new patients

Locations

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1366442014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N ALVERNON WAY",
            "address_2": "STE 250",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111843",
            "telephone_number": "520-647-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "address_2": "CARONDELET ST. JOSEPH'S HOSPITAL EMERGENCY DEPT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85711",
            "telephone_number": "520-873-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "RANDALL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "11045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201658",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.