East Tucson Im & Geriatrics, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

30466 Issued in AZ

Legal business name

EAST TUCSON IM & GERIATRICS, INC

Practice address

6556 E Carondelet Dr
Tucson, AZ 85710-2117

Phone

(520) 296-8733

Fax

(520) 296-8734

NPI assigned

Oct 31, 2005

Organization subpart

Yes

Parent organization

EAST TUCSON IM & GERIATRICS, INCAs reported in NPPES

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

Authorized official

Name

Dr. Ramakrishnan Subbureddiar, MD

Title

President

Phone

(520) 296-8733

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

East Tucson Im Geriatrics

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ram Subbureddiar, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1326016221
  Medicare reassignment

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1619968419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6556 E CARONDELET DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102117",
            "telephone_number": "520-296-8733",
            "fax_number": "520-296-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6556 E CARONDELET DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102117",
            "telephone_number": "520-296-8733",
            "fax_number": "520-296-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TUCSON IM & GERIATRICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST TUCSON IM & GERIATRICS, INC",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "SUBBUREDDIAR",
        "authorized_official_first_name": "RAMAKRISHNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-296-8733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "30466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.