Jack Hannallah, MD, MBA, MPH

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

51583 Issued in AZ

Practice address

1625 N Campbell Ave
Tucson, AZ 85719-4330

Phone

(520) 694-0111

NPI assigned

Jun 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

University of Arizona College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064
• Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

Merit-based Incentive Payment System (MIPS)

Final score

93.34 of 100Reported as apm

Quality

74.56

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

Practice roles

Locations

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.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Banner - University Hospital Based Physicians LLC

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1750751566
  Medicare reassignment NPD
• Modern Vascular of Tucson, LLC

  • Vascular & Interventional Radiology Physician
  • Tucson, AZ
  • NPI 1255896544
  Medicare reassignment NPD
• Banner - University Hospital Based Physicians LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1538879481
  NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD

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

• Banner - University Medical Center South Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1558759498
  Care Compare affiliation
• Banner - University Medical Center South Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1922660182

  Hospital

  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179
  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1861102881

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1497018915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RADIOLOGY AND IMAGING SERVICES",
            "address_2": "1625 N CAMPBELL AVE.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNALLAH",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD, MBA, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2025-07-03",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "51583",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AZ",
            "license": "51583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Lee Hannah, NP
• Crisanta T Hannah, NONE
• Hannah C Hannah, LAMFT
• Tim Mark Hannah
• Arthi Hannallah, MD
• John Patrick Hannan, PEER SUPPORT SPECIAL
• Katlyn Hannan, PT, DPT
• Matthew North Hannan, D.D.S.
• Philipp Lorenz Hannan, M.D.
• Bryan M Hannley, P.T.

• Vascular & Interventional Radiology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Vascular & Interventional Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.