Individual provider Active NPI

Iman Ghaderi, MD

  • Surgery Physician
  • Tucson, AZ
National Provider Identifier
1790069847
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
48757 Issued in AZ
Practice address
3950 S Country Club Rd
Suite 200
Tucson, AZ 85714-2099
Phone
(919) 966-4131
NPI assigned
Oct 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 48757 AZ Primary

Addresses

Primary practice location

3950 S Country Club Rd
Suite 200
Tucson, AZ 85714-2099

Mailing address

3950 S Country Club Rd
Suite 200
Tucson, AZ 85714-2099
Phone (919) 966-4131

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140708001224 AZ Practitioner - General Surgery 7911171871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

2800 E Ajo Way
Tucson, AZ 85713-6204

3838 N Campbell Ave
Tucson, AZ 85719-1454

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064
  • Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux48
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48757AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jun 18, 2014 Accepting new patients
Banner-University Medical Group CurrentSince Jun 18, 2014 Accepting new patients
University of North Carolina at Chapel Hill Surgery Past Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

3950 S Country Club Rd
Ste 200
Tucson, AZ 85714
Phone (520) 626-5582

3838 N Campbell Ave
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

3838 N Campbell Ave
#2
Tucson, AZ 85719

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1790069847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD",
            "address_2": "SUITE 200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142099",
            "telephone_number": "919-966-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD",
            "address_2": "SUITE 200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142099",
            "telephone_number": "919-966-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHADERI",
        "first_name": "IMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-07",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "48757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.