Active NPI
Brian Tiffany, M.D.
- Emergency Medical Services (Emergency Medicine) Physician
- Chandler, AZ
National Provider Identifier
1578518486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 25898
- Practice address
- 475 S Dobson Rd
Chandler, AZ 85224-5605 - Phone
- (480) 917-1648
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25898 | AZ | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 25898 | AZ | Primary |
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician | 207PE0005X | 25898 | AZ |
Addresses
Primary practice location
475 S Dobson Rd
Chandler, AZ 85224-5605
Mailing address
2625 N 24TH St
Mesa, AZ 85213-1470
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 408882-05 | Medicaid | AZ | |
| AZ0736120 | Other | AZ | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25898 | AZ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ingenuity Medical Group LLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1417986118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279497600000",
"number": "1578518486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 N 24TH ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852131470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 S DOBSON RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852245605",
"telephone_number": "480-917-1648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIFFANY",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2010-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AZ",
"license": "25898",
"primary": false
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "AZ",
"license": "25898",
"primary": true
},
{
"code": "207PE0005X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
"state": "AZ",
"license": "25898",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "408882-05",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "AZ0736120",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.