Individual provider Active NPI

Ethan Allen Neufeld, M.D.

  • Neuroradiology Physician
  • Tucson, AZ
National Provider Identifier
1487920815
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
57623 Issued in AZ
Practice address
677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone
(520) 795-2889
NPI assigned
Mar 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10179216-1205 UT
Neuroradiology Physician 2085N0700X 57623 AZ Primary

Addresses

Primary practice location

677 N Wilmot Rd
Tucson, AZ 85711-2701

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Other practice location 1

2492 E River Rd
Tucson, AZ 85718-9552
Phone (520) 335-6849

Other identifiers 1

IdentifierTypeStateIssuer
513683MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, 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
I20180809005718 UT Practitioner - Diagnostic Radiology 5698044667 Reassigns benefits to 1 organization
I20190604001335 AZ Practitioner - Diagnostic Radiology 5698044667 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology LTD LLCGroup PAC ID 6204727589, 107 clinicians

Practice addresses (Care Compare)

1598 W Commerce CT
Suite a
Tucson, AZ 85746-6015
Phone (520) 290-4842

2551 E Vistoso Commerce Loop
Oro Valley, AZ 85755-9124
Phone (520) 825-1990

395 N Silverbell Rd
Suite 185
Tucson, AZ 85745-2721
Phone (520) 872-6900

400 W Camino Casa Verde
Suite 200
Green Valley, AZ 85614-3569
Phone (520) 648-9480

450 W Continental Rd
Green Valley, AZ 85622-3551
Phone (520) 625-7670

4640 E Camp Lowell Dr
Tucson, AZ 85712-1296
Phone (520) 318-6144

5960 N la Cholla Blvd
Tucson, AZ 85741-3535
Phone (520) 290-4848

677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone (520) 571-9599

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
75.27
Improvement activities
40
Cost
74.3

Merit-based Incentive Payment System (MIPS)

Final score
97.01 of 100Reported as group
Quality
95
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Radiology L L C Diagnostic Radiology CurrentSince Mar 25, 2020 Accepting new patients
Arizona Oncology Associates PC Diagnostic Radiology CurrentSince Mar 25, 2020 Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Jun 10, 2018 Accepting new patients
RLC LLC Neuroradiology CurrentSince Sep 1, 2024 Accepting new patients
Radiology LTD., LLC Diagnostic Radiology CurrentSince Oct 29, 2023 Accepting new patients
Arizona Blood and Cancer Specialists, PLLC CurrentSince Jan 10, 2021 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Southern Arizona Rad Associates, LLC Diagnostic Radiology CurrentSince Mar 25, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Jun 10, 2018 Accepting new patients

Locations

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

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

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

155 Calle Portal
Ste 500
Sierra Vista, AZ 85635
Phone (520) 459-5227

151 Colonia de Salud
Sierra Vista, AZ 85635
Phone (520) 263-3900

2951 N Swan Rd
Ste 155
Tucson, AZ 85712
Phone (520) 323-5900

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

5960 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 290-4848

677 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 571-9599

3945 E Paradise Falls Dr
Ste 201
Tucson, AZ 85712
Phone (520) 290-5888

2625 N Craycroft Rd
Ste 20
Tucson, AZ 85712
Phone (520) 324-2409

2492 E River Rd
Tucson, AZ 85718
Phone (520) 335-6849

3945 E Paradise Falls Dr
Ste 105
Tucson, AZ 85712
Phone (520) 689-7022

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1487920815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2492 E River Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857189552",
            "country_code": "US",
            "telephone_number": "520-335-6849",
            "fax_number": "520-459-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEUFELD",
        "first_name": "ETHAN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "10179216-1205",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "AZ",
            "license": "57623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "513683",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.