Individual provider Active NPI

Anirudh Gururaj

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1558115741
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R80803 Issued in AZ
Practice address
3950 S Country Club Rd Ste 130
Tucson, AZ 85714-2203
Phone
(520) 670-3909
NPI assigned
Apr 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R80803 AZ Primary

Addresses

Primary practice location

3950 S Country Club Rd Ste 130
Tucson, AZ 85714-2203

Mailing address

3950 S Country Club Rd Ste 130
Tucson, AZ 85714-2203

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
I20240712001304 AZ Order and Referring Only - Family PracticePractitioner - Family Practice 2163967217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1558115741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD STE 130",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD STE 130",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142203",
            "telephone_number": "520-670-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURURAJ",
        "first_name": "ANIRUDH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R80803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.