NPIMap

Individual provider Active NPI

Sutapa Dube, M.D.

  • Child & Adolescent Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1730495201
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
52944 Issued in AZ
Practice address
1120 N 5TH Ave
Tucson, AZ 85705-7408
Phone
(520) 881-1292
Fax
(520) 818-1648
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine Physician 202D00000X 52944 AZ
Forensic Psychiatry Physician 2084F0202X 52944 AZ
Psychiatry Physician 2084P0800X 52944 AZ
Child & Adolescent Psychiatry Physician 2084P0804X 52944 AZ Primary

Addresses

Primary practice location

1120 N 5TH Ave
Tucson, AZ 85705-7408

Mailing address

4729 E Sunrise Dr # 246
Tucson, AZ 85718-4534
Phone (520) 222-7811

Other practice location 1

1501 N Campbell Ave
Outpatient Psychiatry Clinic
Tucson, AZ 85724-5002
Phone (520) 626-7240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52944AZMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Casa de Los Ninos CurrentSince Jan 17, 2021 Accepting new patients
Casa de Los Ninos, Inc. CurrentSince Oct 10, 2021 Accepting new patients
CH MH Services (Ny), LLC PastSince Oct 1, 2023 Accepting new patients
CH MH Services (Az), LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sutapa.dube@489656322949124.direct.elationemr.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1730495201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 E SUNRISE DR # 246",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857184534",
            "telephone_number": "520-222-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N 5TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857057408",
            "telephone_number": "520-881-1292",
            "fax_number": "520-818-1648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_2": "Outpatient Psychiatry Clinic",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857245002",
            "country_code": "US",
            "telephone_number": "520-626-7240",
            "fax_number": "520-626-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBE",
        "first_name": "SUTAPA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "AZ",
            "license": "52944",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "AZ",
            "license": "52944",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "52944",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AZ",
            "license": "52944",
            "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 28, 2024; 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.