NPIMap

Organization Active NPI

Swan Gastroenterology, P.C.

  • Gastroenterology Physician
  • Tucson, AZ
National Provider Identifier
1619368891
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
38120 Issued in AZ
Legal business name
SWAN GASTROENTEROLOGY, P.C.
Practice address
1505 N Swan Rd
121
Tucson, AZ 85712-4044
Phone
(520) 795-3090
Fax
(520) 795-3586
NPI assigned
Feb 10, 2015
Last updated
Feb 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Fadi Deeb, MDNPI 1497729248
Title
Owner
Phone
(520) 795-3090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 38120 AZ Primary

Addresses

Primary practice location

1505 N Swan Rd
121
Tucson, AZ 85712-4044

Mailing address

1505 N Swan Rd
121
Tucson, AZ 85712-4044
Phone (520) 795-3090

Other names 2

  • Consultants In Gastroenterology, P.C. Former legal business name
  • Consultants In Gastroenterology, PC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160304001732 AZ Part B Supplier - Clinic/Group Practice 9133425903 Receives reassigned benefits from 14 practitioners
Practice locations: Sierra Vista, AZ; Tucson, AZ

National Provider Directory

National Provider Directory

Locations

1505 N Swan Rd
#121
Tucson, AZ 85712
Phone (520) 795-3090

1505 N Swan Rd
Ste 121
Tucson, AZ 85712
Phone (520) 795-3090

5190 E Farness Dr
Ste 112
Tucson, AZ 85712
Phone (520) 795-3090

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1619368891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 N SWAN RD",
            "address_2": "121",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124044",
            "telephone_number": "520-795-3090",
            "fax_number": "520-795-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 N SWAN RD",
            "address_2": "121",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124044",
            "telephone_number": "520-795-3090",
            "fax_number": "520-795-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAN GASTROENTEROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "DEEB",
        "authorized_official_first_name": "FADI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-795-3090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "38120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consultants In Gastroenterology, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Consultants In Gastroenterology, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.