Individual provider Active NPI

John Moses Azizian

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1669933164
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R79950 Issued in AZ
Practice address
1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone
(520) 694-0111
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A178673 CA
Internal Medicine Physician 207R00000X R79950 AZ Primary

Addresses

Primary practice location

1625 N Campbell Ave
Tucson, AZ 85719-4330

Mailing address

1515 Greenbriar Rd
Glendale, CA 91207-1535
Phone (818) 605-0553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260625004827 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0042607871

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Wake Forest University School of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1530 E Chevy Chase Dr
Suite 203
Glendale, CA 91206-4194

PO Box
Suite 842176
Los Angeles, CA 90084-2176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R79950AZMDInternal Medicine Physician
A178673CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1669933164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 GREENBRIAR RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071535",
            "telephone_number": "818-605-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZIAN",
        "first_name": "JOHN",
        "middle_name": "MOSES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A178673",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R79950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.