Individual provider Active NPI

Masresha G Akalu, NP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1558634709
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN145993 Issued in AZ
Practice address
2122 N Craycroft Rd
Suite 102
Tucson, AZ 85712-2849
Phone
(520) 722-2400
Fax
(520) 323-7531
NPI assigned
Feb 20, 2012
Last updated
Mar 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN145993 AZ Primary

Addresses

Primary practice location

2122 N Craycroft Rd
Suite 102
Tucson, AZ 85712-2849

Mailing address

2122 N Craycroft Rd
Suite 102
Tucson, AZ 85712-2849
Phone (520) 722-2400

Other identifiers 1

IdentifierTypeStateIssuer
684438MedicaidAZ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000003 AZ Practitioner - Nurse Practitioner 5294994547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.68 of 100Reported as group
Quality
100
Improvement activities
40
Cost
69.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN145993AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Medical Partners CurrentSince Dec 1, 2017 Accepting new patients
Catalina Hospice PLLC PastSince Sep 20, 2020 Accepting new patients
For Health of Arizona, Inc. Past Accepting new patients

Locations

1700 E River Rd
Unit 65177
Tucson, AZ 85728
Phone (520) 635-9103

2675 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 260-0937

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1558634709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 N CRAYCROFT RD",
            "address_2": "SUITE 102",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122849",
            "telephone_number": "520-722-2400",
            "fax_number": "520-323-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 N CRAYCROFT RD",
            "address_2": "SUITE 102",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122849",
            "telephone_number": "520-722-2400",
            "fax_number": "520-323-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKALU",
        "first_name": "MASRESHA",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-20",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN145993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "684438",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.