Individual provider Active NPI

Joseph Patrick Shortall, DO

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1639661325
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
010213 Issued in AZ
Practice address
3655 E Grant Rd
Tucson, AZ 85716-2933
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
May 30, 2018
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 010213 AZ
Psychiatry Physician 2084P0800X 010213 AZ Primary

Addresses

Primary practice location

3655 E Grant Rd
Tucson, AZ 85716-2933

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240712001657 AZ Practitioner - PsychiatryPractitioner - Addiction Medicine 8426387838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc Current Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Jul 1, 2024 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Jul 1, 2024 Accepting new patients
SMSJ Tucson Holdings LLC Past Accepting new patients
SMSJ Tucson Holdings LLC Past Accepting new patients

Locations

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

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

Organizations & group practices 5

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1639661325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857162933",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTALL",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "AZ",
            "license": "010213",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "010213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.