Active NPI
Keystone Medical, PLLC
- Internal Medicine Physician
- Tucson, AZ
National Provider Identifier
1477975647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 32180
- Legal business name
- KEYSTONE MEDICAL, PLLC
- Practice address
- 6211 N la Cholla Blvd
Tucson, AZ 85741-3528 - Phone
- (520) 575-0900
- Fax
- (520) 547-2382
- NPI assigned
- Jan 7, 2014
- Last updated
- Feb 11, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rebecca Pradhan-Nara, MD
- Title
- Sole Member
- Phone
- (520) 266-4338
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 32180 | AZ | Primary |
| Assisted Living Facility | 310400000X | 32180 | AZ | |
| Skilled Nursing Facility | 314000000X | 32180 | AZ |
Addresses
Primary practice location
6211 N la Cholla Blvd
Tucson, AZ 85741-3528
Mailing address
PO Box 43100
Tucson, AZ 85733-3100
Phone (520) 722-3777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 897280 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Scottsdale, AZ
- NPI 1497405229
-
- Internal Medicine Physician
- Tucson, AZ
- NPI 1083602700
-
- Family Nurse Practitioner
- Tucson, AZ
- NPI 1871935445
-
- Family Nurse Practitioner
- Tucson, AZ
- NPI 1093955023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739232000000",
"number": "1477975647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43100",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857333100",
"telephone_number": "520-722-3777",
"fax_number": "520-547-2382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6211 N LA CHOLLA BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857413528",
"telephone_number": "520-575-0900",
"fax_number": "520-547-2382"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KEYSTONE MEDICAL, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-07",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A",
"authorized_official_last_name": "PRADHAN-NARA",
"authorized_official_first_name": "REBECCA",
"authorized_official_title_or_position": "SOLE MEMBER",
"authorized_official_telephone_number": "520-266-4338",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "AZ",
"license": "32180",
"primary": true
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "32180",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "AZ",
"license": "32180",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "897280",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.