TLC Healthcare Medical Group PC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

TLC HEALTHCARE MEDICAL GROUP PC

Practice address

5130 North Circulo Sobrio
Tucson, AZ 85718-6036

Phone

(520) 670-0745

Fax

(520) 509-4496

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Scott M Bolhack, MDNPI 1730160573

Title

Owner/Authorized Official

Phone

(520) 670-0745

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Scott M Bolhack MD PC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott M Bolhack, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1730160573

  AZ, Internal Medicine

  Medicare reassignment NPD Authorized official
• Deborah Ruth Hotep, ARNP

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1043210057

  AZ

  Medicare reassignment NPD
• Kathryn M Tynan, NP

  • Adult Health Nurse Practitioner
  • Cypress, CA
  • NPI 1508857095

  AZ

  Medicare reassignment NPD
• Mario R Munoz, PA-C

  • Physician Assistant
  • Tucson, AZ
  • NPI 1720167042
  NPD
• Christine Parks, NP

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1922480706
  NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1720157464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 NORTH COUNTRY CLUB ROAD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161910",
            "telephone_number": "520-322-6274",
            "fax_number": "520-509-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 NORTH CIRCULO SOBRIO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186036",
            "telephone_number": "520-670-0745",
            "fax_number": "520-509-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC HEALTHCARE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "BOLHACK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "520-670-0745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "20393",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "20393",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328958",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott M Bolhack MD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rishita Tiwari, M.D.
• Nicholas Tjalas
• Titus Tjalas, FNP-BC, PMHNP-BC
• Elysia Tjong, DO
• TKS Psychiatry
• TLC Healthcare Wound Specialists Inc
• TLC Medical Group - Catalina Foothills
• TLC Medical LLC
• TLC Pain & Palliative Medicine Practice, Inc
• TLC Pediatrics Tucson, PLLC.

• All providers in Tucson, AZ
• Geriatric Medicine (Family Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.