Individual provider Active NPI

Robert Lystrup, MD

  • Sports Medicine (Family Medicine) Physician
  • Tucson, AZ
National Provider Identifier
1679957427
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
58675 Issued in AZ
Practice address
2260 N Rosemont Blvd
Tucson, AZ 85712-2137
Phone
(520) 318-1033
Fax
(520) 318-1338
NPI assigned
Jul 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 58675 AZ Primary
Family Medicine Physician 207Q00000X LL2644 NV
Family Medicine Physician 207Q00000X 58675 AZ

Addresses

Primary practice location

2260 N Rosemont Blvd
Tucson, AZ 85712-2137

Mailing address

4801 E Broadway Blvd Ste 251
Tucson, AZ 85711-2700
Phone (520) 327-0460

Other practice location 1

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-2273

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
I20230809001617 AZ Practitioner - Family Practice 1557677465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Community Physicians PCGroup PAC ID 4587560552, 162 clinicians

Practice addresses (Care Compare)

2260 N Rosemont Blvd
Suite 107
Tucson, AZ 85712-2137
Phone (520) 318-1033

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Tucson, AZ, CCN 037213
  • Centerwell Home Health Home health agency, Tucson, AZ, CCN 037036
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58675AZMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physicians PC Family Medicine CurrentSince Nov 12, 2023 Accepting new patients
Arizona Community Physician PC CurrentSince Sep 25, 2023 Accepting new patients

Locations

2260 N Rosemont Blvd
Tucson, AZ 85712
Phone (520) 318-1033

2260 N Rosemont Blvd
Ste 107
Tucson, AZ 85712
Phone (520) 318-1033

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

Interoperability endpoints

  • Direct secure messaging: rlystrup20530@azacp.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1679957427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 E BROADWAY BLVD STE 251",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112700",
            "telephone_number": "520-327-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 N ROSEMONT BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122137",
            "telephone_number": "520-318-1033",
            "fax_number": "520-318-1338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYSTRUP",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "58675",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "LL2644",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "58675",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.