Individual provider Active NPI

Mark Alan Tiffany, MD

  • Anesthesiology Physician
  • Tucson, AZ
National Provider Identifier
1407964737
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
64010 Issued in AZ
Practice address
4601 E Broadway Blvd
Tucson, AZ 85711-3511
Phone
(520) 399-6000
Fax
(520) 399-6002
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X MD2022-1545 NM
Anesthesiology Physician 207L00000X 64010 AZ Primary

Addresses

Primary practice location

4601 E Broadway Blvd
Tucson, AZ 85711-3511

Mailing address

4601 E Broadway Blvd
Tucson, AZ 85711-3511
Phone (520) 399-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230127000019 NM Practitioner - Pain Management 7719940881 Reassigns benefits to 1 organization
I20240625002258 AZ Practitioner - Pain Management 7719940881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
University of California, San Diego School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emil H Annabi MD PCGroup PAC ID 0941511109, 10 clinicians

Practice addresses (Care Compare)

4601 E Broadway Blvd
Tucson, AZ 85711-3511
Phone (520) 399-6000

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2022-1545NMMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emil H Annabi MD PC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Emil H Annabi MD PC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
New Mexico Bone and Joint Institute PC CurrentSince Feb 1, 2023 Accepting new patients
New Mexico Bone and Joint Institute PC CurrentSince Feb 1, 2023 Accepting new patients
Carolina Pain and Weight Loss, PA PastSince Mar 29, 2019 Accepting new patients
Emil H Annabi MD PC Anesthesiology PastSince Feb 18, 2024 Accepting new patients

Locations

4485 S I 19 Frontage Rd
#100
Green Valley, AZ 85614
Phone (520) 399-6000

13395 N Marana Main St
Fl 2
Marana, AZ 85653
Phone (520) 399-0000

2158 N Gilbert Rd
Ste 121
Mesa, AZ 85203
Phone (480) 461-0150

1310 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 399-6000

4601 E Broadway Blvd
Tucson, AZ 85711
Phone (520) 399-6000

6226 E Pima St
Ste 3
Tucson, AZ 85712
Phone (520) 323-1600

6840 E Broadway Blvd
Tucson, AZ 85710
Phone (520) 399-6000

2275 W Magee Rd
Ste 111
Tucson, AZ 85742
Phone (520) 399-6000

7530 N Oracle Rd
Ste 200
Tucson, AZ 85704
Phone (520) 399-6000

2301 Indian Wells Rd
Ste A
Alamogordo, NM 88310
Phone (505) 434-0639

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1407964737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113511",
            "telephone_number": "520-399-6000",
            "fax_number": "520-399-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113511",
            "telephone_number": "520-399-6000",
            "fax_number": "520-399-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NM",
            "license": "MD2022-1545",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "64010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.