Carl J Pergam, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

29455 Issued in AZ

Practice address

677 N Wilmot Rd
Tucson, AZ 85711-2701

Phone

(520) 795-2889

Fax

(520) 795-6321

NPI assigned

Jan 27, 2006

Last updated

Feb 5, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• RLC LLC

  dba Radiology Ltd. - Carondelet

  • Diagnostic Radiology Physician
  • Tucson, AZ
  • NPI 1528224904
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1629049861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889",
            "fax_number": "520-795-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889",
            "fax_number": "520-795-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERGAM",
        "first_name": "CARL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "29455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "638512",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Magdalena Perez
• Perfect Teeth - North Wilmot PC
• Perfect Teeth / Abc P.C.
• Perfect Teeth / Continental Ranch P.C.
• Performance Enhancement and Rehabilitation Inc
• Mandy Perigo, CTRS
• Rafael F Perini, MD
• Keli Marie Perino, RDN
• Perio Az LLC (Graig D. Brown, DDS)
• Robert Fleming Perkin, DMD,MPH

• 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 Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.