Individual provider Active NPI

Michael David Seckeler, MD

  • Pediatric Cardiology Physician
  • Tucson, AZ
National Provider Identifier
1568506186
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
35588 Issued in AZ
Practice address
1501 N Campbell Av
Room 3302
Tucson, AZ 85724
Phone
(520) 626-5585
Fax
(520) 626-6571
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Congenital Heart Disease Physician 207RA0002X 35588 AZ
Pediatrics Physician 208000000X 35588 AZ
Pediatric Cardiology Physician 2080P0202X 35588 AZ Primary
Pediatrics Physician 208000000X 0418 MP
Pediatric Cardiology Physician 2080P0202X 0101245020 VA

Addresses

Primary practice location

1501 N Campbell Av
Room 3302
Tucson, AZ 85724

Mailing address

Banner University Medical Center
PO Box 245073
Tucson, AZ 85724
Phone (520) 626-5585

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
I20130801000056 AZ Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 0143307645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Maryland School of Medicine, 2003
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)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

2800 E Ajo Way
Tucson, AZ 85713-6204

6365 E Tanque Verde Rd
BLDG E Suite 100
Tucson, AZ 85715-3839
Phone (520) 694-6220

707 N Alvernon Way
Suite 301
Tucson, AZ 85711-1848
Phone (520) 694-1460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35588AZMDPediatrics Physician
0101245020VAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jul 15, 2013 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Jul 15, 2013 Accepting new patients
Children's Clinics for Rehabilitative Services CurrentSince Aug 1, 2013 Accepting new patients

Locations

1209 W Target Range Rd
Ste 104
Nogales, AZ 85621
Phone (520) 882-0696

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

2600 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 324-3600

6261 N La Cholla Blvd
Ste 131
Tucson, AZ 85741
Phone (301) 984-1979

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

2167 W Orange Grove Rd
Tucson, AZ 85741
Phone (520) 544-7650

2701 E Elvira Rd
Tucson, AZ 85756
Phone (520) 874-4024

6365 E Tanque Verde Rd
Ste 100
Tucson, AZ 85715
Phone (520) 694-6220

1625 N Campbell Ave
Tucson, AZ 85719

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

1501 N Campbell Ave
Rm 3302
Tucson, AZ 85724
Phone (520) 626-5585

2851 S Avenue B
Ste 2001
Yuma, AZ 85364
Phone (928) 336-2434

Organizations & group practices 3

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1568506186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BANNER UNIVERSITY MEDICAL CENTER",
            "address_2": "PO BOX 245073",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85724",
            "telephone_number": "520-626-5585",
            "fax_number": "520-626-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AV",
            "address_2": "ROOM 3302",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85724",
            "telephone_number": "520-626-5585",
            "fax_number": "520-626-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECKELER",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "AZ",
            "license": "35588",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "35588",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "35588",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MP",
            "license": "0418",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101245020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.