NPIMap

Organization Active NPI

Southwest Premier Urology, LLC

  • Urology Physician
  • Tucson, AZ
National Provider Identifier
1720614241
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SOUTHWEST PREMIER UROLOGY, LLC
Practice address
1100 N El Dorado PL
Tucson, AZ 85715-4606
Phone
(520) 324-4660
Fax
(520) 324-4659
NPI assigned
Mar 16, 2020
Last updated
Mar 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Authorized official

Name
Tristan T Berry, MDNPI 1366572356
Title
Owner
Phone
(520) 324-4660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

1100 N El Dorado PL
Tucson, AZ 85715-4606

Mailing address

PO Box 43100
Tucson, AZ 85733-3100
Phone (520) 722-3777

National Provider Directory

National Provider Directory

Locations

1100 N El Dorado Pl
Tucson, AZ 85715
Phone (520) 296-7169

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1720614241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857333100",
            "telephone_number": "520-722-3777",
            "fax_number": "520-296-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N EL DORADO PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154606",
            "telephone_number": "520-324-4660",
            "fax_number": "520-324-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PREMIER UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-324-4660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.