Tara Selean Alexander, PA C
Individual provider Active NPI Physician Assistant · Tucson, AZ
NPI 1720160732 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720160732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2575 (AZ)
- Practice address
- 5301 E Grant Road
Tucson Medical Center Emergency Department
Tucson, AZ 85712-2805 - Phone
- (520) 324-1922
- Fax
- (520) 324-1088
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100715000877 | AZ | Practitioner - Physician Assistant | 1355473075 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2575 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swea, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2575 | AZ | Yes |
Addresses
Primary practice location
5301 E Grant Road
Tucson Medical Center Emergency Department
Tucson, AZ 85712-2805
Mailing address
5700 E Pima Street
Suite B
Tucson, AZ 85712-5601
Phone (520) 382-2819
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 773251 | Other | AZ | AHCCCS |
| 773251-01 | Medicaid | AZ | |
| P00092177 | Other | RAILROAD MCR |
Other providers in Tucson, AZ
- Kolton Levi Tanner Alexander
- Laurel C Alexander
- Macie Alexander
- Manu Alexander
- Shannon Marie Alexander
- Mohamed Alfaris
- Armando J Alfaro Jr.
- Ashraf Ibrahim Alfatesh
- Rosa Maria Alfonso
- Alfredo C. Ramirez, MD PLLC
All providers in Tucson, AZ · Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.