Individual provider Active NPI

Michael Ryan Hubbard, D.O.

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1376777268
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A11587 Issued in CA
Practice address
320 W Prince Rd
Tucson, AZ 85705-3526
Phone
(309) 520-4200
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A11587 CA Primary

Addresses

Primary practice location

320 W Prince Rd
Tucson, AZ 85705-3526

Mailing address

320 W Prince Rd
Tucson, AZ 85705-3526
Phone (309) 520-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120829000352 CA Practitioner - Internal Medicine 5193972024
I20161207000097 TX Practitioner - Internal Medicine 5193972024 Reassigns benefits to 1 organization
I20211104001781 AZ Practitioner - Internal Medicine 5193972024 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11587CAMDInternal Medicine Physician
11587CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Oct 30, 2016 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Nov 1, 2021 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Nov 1, 2021 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Oct 30, 2016 Accepting new patients
Kevin Parzych a Medical Corp Family Medicine PastSince Apr 16, 2020 Accepting new patients

Locations

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

320 W Prince Rd
Tucson, AZ 85705
Phone (520) 838-7663

Organizations & group practices 5

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1376777268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W PRINCE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053526",
            "telephone_number": "309-520-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W PRINCE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053526",
            "telephone_number": "309-520-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "MICHAEL",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.