Individual provider Active NPI

Salvatore J Liotta, PA

  • Medical Physician Assistant
  • Tucson, AZ
National Provider Identifier
1417419565
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7548 Issued in AZ
Practice address
2121 N Craycroft Rd BLDG 5
Tucson, AZ 85712-2845
Phone
(520) 296-8500
NPI assigned
Apr 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 7548 AZ Primary

Addresses

Primary practice location

2121 N Craycroft Rd BLDG 5
Tucson, AZ 85712-2845

Mailing address

2121 N Craycroft Rd BLDG 5
Tucson, AZ 85712-2845
Phone (520) 296-8500

Other practice location 1

1358 W Orange Grove Rd
Tucson, AZ 85704-2901
Phone (520) 296-8500

Other identifiers 3

IdentifierTypeStateIssuer
1167568OtherAZNCCPA
7548OtherAZARIZONA MEDICAL BOARD
584017MedicaidAZ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191022000343 AZ Practitioner - Physician Assistant 8325370588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurological Associates of TucsonGroup PAC ID 5092709527, 60 clinicians
Tucson E.N.T. Associates, P.C.Group PAC ID 9931093853, 15 clinicians

Practice addresses (Care Compare)

1358 W Orange Grove Rd
Tucson, AZ 85704-2901
Phone (520) 575-1272

2450 E River Rd
Tucson, AZ 85718-6522

2450 E River Rd
Tucson, AZ 85718-6526
Phone (520) 795-7750

6567 E Carondelet Dr
Suite 515
Tucson, AZ 85710-6158
Phone (520) 296-8500

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson E.N.T. Associates, P.C. CurrentSince Sep 28, 2022 Accepting new patients
Valley ENT, PC Past Accepting new patients

Locations

1600 S 20th Ave
Safford, AZ 85546
Phone (928) 348-4000

6567 E Carondelet Dr
Ste 515
Tucson, AZ 85710
Phone (520) 296-8500

1358 W Orange Grove Rd
Tucson, AZ 85704
Phone (520) 296-8500

2121 N Craycroft Rd
Bldg 5
Tucson, AZ 85712
Phone (520) 296-8500

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.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1417419565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N CRAYCROFT RD BLDG 5",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122845",
            "telephone_number": "520-296-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N CRAYCROFT RD BLDG 5",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122845",
            "telephone_number": "520-296-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1358 W Orange Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857042901",
            "country_code": "US",
            "telephone_number": "520-296-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIOTTA",
        "first_name": "SALVATORE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1167568",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL BOARD",
            "identifier": "7548",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "584017",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.