Individual provider Active NPI

Stephen Stanley Kaczynski, D.O.

  • Anesthesiology Physician
  • Tucson, AZ
National Provider Identifier
1508811571
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4570 Issued in AZ
Practice address
3390 N Campbell Ave
Ste 110
Tucson, AZ 85719-2380
Phone
(520) 795-7650
Fax
(520) 325-1622
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 02002289A IN
Anesthesiology Physician 207L00000X 4570 AZ Primary

Addresses

Primary practice location

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719-2380

Mailing address

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719-2380
Phone (520) 795-7650

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000165 AZ Practitioner - Anesthesiology 9436243342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Arizona Anesthesia Services PCGroup PAC ID 1850382565, 44 clinicians

Practice addresses (Care Compare)

3390 N Campbell Ave
Suite 110
Tucson, AZ 85719-2380
Phone (520) 795-7650

Hospital & facility affiliations

  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02002289AINMDAnesthesiology Physician
4570AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Arizona - Nogales Anesthesiology CurrentSince Sep 16, 2024 Accepting new patients
Southern Arizona Anesthesia Services, PC Anesthesiology CurrentSince Oct 1, 2007 Accepting new patients

Locations

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719
Phone (520) 784-2243

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

5755 S Houghton Rd
Tucson, AZ 85747
Phone (520) 324-1727

Organizations & group practices 2

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 2

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1508811571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE",
            "address_2": "STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650",
            "fax_number": "520-325-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE",
            "address_2": "STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650",
            "fax_number": "520-325-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZYNSKI",
        "first_name": "STEPHEN",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "02002289A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "4570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.