NPIMap

Individual provider Active NPI

Shruti Bala, MD

  • Obstetrics & Gynecology Physician
  • Tucson, AZ
National Provider Identifier
1629464003
Registry record updated Sep 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
58221 Issued in AZ
Practice address
225 W Irvington Rd
Tucson, AZ 85714-3054
Phone
(520) 884-7304
NPI assigned
Apr 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 58221 AZ Primary

Addresses

Primary practice location

225 W Irvington Rd
Tucson, AZ 85714-3054

Mailing address

1 Medical Center Dr
DHMC... Department of Obstetrics and Gynecology
Lebanon, NH 03756-1000

Other practice location 1

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 324-5524

Other identifiers 1

IdentifierTypeStateIssuer
529135MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190916003497 AZ Practitioner - Obstetrics/Gynecology 1355632399 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arizona College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Rio Santa Cruz Neighborhood Health Center, Inc.Group PAC ID 6305739244, 283 clinicians

Practice addresses (Care Compare)

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58221AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Aug 1, 2019 Accepting new patients
TMC Medical Network CurrentSince Jul 1, 2021 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Aug 1, 2019 Accepting new patients
Tucson Medical Center Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients

Locations

1500 W Commerce Ct
Bldg 1
Tucson, AZ 85746
Phone (520) 309-3006

3655 E Grant Rd
Tucson, AZ 85716
Phone (520) 440-6323

225 W Irvington Rd
Tucson, AZ 85714
Phone (520) 670-3857

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

101 W Irvington Rd
Bldg 3C
Tucson, AZ 85714
Phone (520) 573-0096

320 W Prince Rd
Tucson, AZ 85705
Phone (520) 838-7663

6950 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 309-3250

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

Organizations & group practices 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631404800000",
    "number": "1629464003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC... DEPARTMENT OF OBSTETRICS AND GYNECOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W IRVINGTON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857143054",
            "telephone_number": "520-884-7304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122805",
            "country_code": "US",
            "telephone_number": "520-324-5524",
            "fax_number": "520-324-2927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALA",
        "first_name": "SHRUTI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-12",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "58221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529135",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.