Organization Active NPI

Desert Sage Behavioral Health, PLC

  • Psychiatric/Mental Health Registered Nurse
  • Tucson, AZ
National Provider Identifier
1750736724
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
RN103631 Issued in AZ
Legal business name
DESERT SAGE BEHAVIORAL HEALTH, PLC
Practice address
7090 N Oracle Rd
Suite 178-203
Tucson, AZ 85704-4333
Phone
(866) 213-0445
Fax
(866) 531-9559
NPI assigned
Apr 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Authorized official

Name
Daniel Chafetz, NPNPI 1932130887
Title
Owner
Phone
(866) 213-0445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X RN103631 AZ Primary

Addresses

Primary practice location

7090 N Oracle Rd
Suite 178-203
Tucson, AZ 85704-4333

Mailing address

7090 N Oracle Rd
Suite 178-203
Tucson, AZ 85704-4333
Phone (866) 213-0445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160517001383 AZ Part B Supplier - Clinic/Group Practice 6406145333 Receives reassigned benefits from 9 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

6899 N La Canada Dr
Tucson, AZ 85704
Phone (520) 531-0086

211 W King Rd
Tucson, AZ 85705
Phone (520) 293-6192

7090 N Oracle Rd
Ste 178203
Tucson, AZ 85704
Phone (480) 353-1686

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1750736724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7090 N ORACLE RD",
            "address_2": "SUITE 178-203",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044333",
            "telephone_number": "866-213-0445",
            "fax_number": "866-531-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7090 N ORACLE RD",
            "address_2": "SUITE 178-203",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044333",
            "telephone_number": "866-213-0445",
            "fax_number": "866-531-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SAGE BEHAVIORAL HEALTH, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "CHAFETZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-213-0445",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN103631",
            "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 Apr 27, 2016; 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.