Kristin Elvemo Jecius, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R78720 Issued in AZ

Practice address

1625 N Campbell Ave
Tucson, AZ 85719-4330

Phone

(520) 694-8888

NPI assigned

May 31, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Diagnostic Radiology

Education

University of Arizona College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner-University Medical GroupGroup PAC ID 7719899871, shared by 2 NPIs, 1,066 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179
  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1861102881

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1588230650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N. CAMPBELL AVE.",
            "address_2": "PO BOX 245067",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JECIUS",
        "first_name": "KRISTIN",
        "middle_name": "ELVEMO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-31",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "R78720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.bannerhealth.com/locations/tucson/banner-university-medical-center-tucson",
            "affiliation": "N",
            "address_1": "1625 N Campbell Ave",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857194330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marie Raphaelle Mona Jean, M.D., MPH
• Michelle Jeannette, M.D.
• Lea Serena Jebara
• Jeca Healthcare Services LLC
• Hunter Jecius, MD
• David Todd Jeck, MD
• Tracy A Jeck, M.D.
• Mahdieh Fazel Jedlowski, MD
• Patrick Michael Jedlowski, MD
• Jeff D Wiese LCSW PLLC

• Diagnostic Radiology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.