Individual provider Active NPI

Peter Craig Kowalski, MD

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1639107444
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16966 Issued in AZ
Practice address
2800 E Ajo Way
Tucson, AZ 85713-6204
Phone
(520) 871-7500
Fax
(208) 747-5395
NPI assigned
Jun 29, 2006
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 16966 AZ
Psychiatry Physician 2084P0800X 16966 AZ Primary

Addresses

Primary practice location

2800 E Ajo Way
Tucson, AZ 85713-6204

Mailing address

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180928001550 OK Practitioner - Psychiatry 4880839208 Reassigns benefits to 1 organization
I20250212003197 AZ Practitioner - Psychiatry 4880839208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Oklahoma College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16966AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine Current Accepting new patients
Banner-University Medical Group CurrentSince Mar 24, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Mar 24, 2025 Accepting new patients
B--Umg Integrated Health Clinic, LLC Past Accepting new patients
East Falls Family Medicine, LLC Family Medicine Past Accepting new patients
Cheryl C. Fuller PHD PA Past Accepting new patients

Locations

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

535 N Wilmot Rd
Fl 2
Tucson, AZ 85711
Phone (520) 694-1234

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1639107444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-874-7500",
            "fax_number": "520-874-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-871-7500",
            "fax_number": "208-747-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "PETER",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AZ",
            "license": "16966",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "16966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.