Active NPI
Carlos Duarte, M.D.
- Family Medicine Physician
- San Carlos, AZ
National Provider Identifier
1639481815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 149740
- Practice address
- 1 Vassar Dr NE
Usphs Indian Hospital
San Carlos, AZ 85550 - Phone
- (928) 475-7190
- NPI assigned
- Jul 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 149740 | AZ | Primary |
Addresses
Primary practice location
1 Vassar Dr NE
Usphs Indian Hospital
San Carlos, AZ 85550
Mailing address
PO Box 208
Usphs Indian Hospital
San Carlos, AZ 85550
Phone (928) 475-7190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149740 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1639481815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 208",
"address_2": "USPHS INDIAN HOSPITAL",
"city": "SAN CARLOS",
"state": "AZ",
"postal_code": "85550",
"telephone_number": "928-475-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VASSAR DR NE",
"address_2": "USPHS INDIAN HOSPITAL",
"city": "SAN CARLOS",
"state": "AZ",
"postal_code": "85550",
"telephone_number": "928-475-7190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "CARLOS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "149740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.