Individual provider Active NPI

Mitchell James Duby, P.A.-C

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1740229988
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1904 Issued in AZ
Practice address
5301 E. Grant Rd.
Orthopaedic BLDG, 1St Floor
Tucson, AZ 85712-8571
Phone
(520) 784-6200
Fax
(520) 784-6109
NPI assigned
Jun 5, 2006
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1904 AZ Primary

Addresses

Primary practice location

5301 E. Grant Rd.
Orthopaedic BLDG, 1St Floor
Tucson, AZ 85712-8571

Mailing address

PO Box 31630
Tucson, AZ 85751-1630
Phone (520) 382-8200

Other identifiers 1

IdentifierTypeStateIssuer
370784MedicaidAZ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050428001171 AZ Practitioner - Physician Assistant 3375582398

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Orthopaedic Institute Professional Corporation Physician Assistant PastSince Aug 8, 2021 Accepting new patients
Valley ENT, PC Past Accepting new patients
Arizona Community Surgeons PC PastSince Aug 1, 2006 Accepting new patients
TMC Medical Network PastSince Mar 31, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1740229988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31630",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511630",
            "telephone_number": "520-382-8200",
            "fax_number": "520-297-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E. GRANT RD.",
            "address_2": "ORTHOPAEDIC BLDG, 1ST FLOOR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857128571",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBY",
        "first_name": "MITCHELL",
        "middle_name": "JAMES",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370784",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.