Individual provider Active NPI

Jennifer Ann Erdrich, M.D.

  • Surgical Oncology Physician
  • Tucson, AZ
National Provider Identifier
1528292802
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
56959 Issued in AZ
Practice address
1501 N Campbell Ave Ste 4327
Tucson, AZ 85724-2200
Phone
(520) 626-9383
NPI assigned
May 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 56959 AZ
Surgical Oncology Physician 2086X0206X 56959 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave Ste 4327
Tucson, AZ 85724-2200

Mailing address

2940 Aber St
San Diego, CA 92117-2424
Phone (858) 752-3695

Other practice location 1

300 Pasteur Dr Rm H3591
Stanford, CA 94305-2200
Phone (650) 736-1355

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
I20181114001083 AZ Practitioner - Surgical Oncology 7012261803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Harvard Medical School, 2009
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)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision33
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Oct 1, 2018 Accepting new patients
Banner-University Medical Group CurrentSince Oct 1, 2018 Accepting new patients

Locations

3533 Canyon de Flores
Ste C
Sierra Vista, AZ 85650
Phone (520) 458-2000

1891 W Orange Grove Rd
Bldg 1
Tucson, AZ 85704
Phone (520) 694-2873

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

2800 E Ajo Way
Ste 100
Tucson, AZ 85713
Phone (520) 874-2778

1501 N Campbell Ave
Ste 4327
Tucson, AZ 85724
Phone (520) 626-9383

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

7165 N Pima Canyon Dr
Tucson, AZ 85718
Phone (520) 694-2021

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": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1528292802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 ABER ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921172424",
            "telephone_number": "858-752-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE STE 4327",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857242200",
            "telephone_number": "520-626-9383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr Rm H3591",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-736-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERDRICH",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-14",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "56959",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "AZ",
            "license": "56959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.