Individual provider Active NPI

Nancy J Favata, PA

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1790743409
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2154 Issued in AZ
Practice address
2155 W Orange Grove Rd
Tucson, AZ 85741-3118
Phone
(520) 742-0414
Fax
(520) 742-6635
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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 2154 AZ Primary

Addresses

Primary practice location

2155 W Orange Grove Rd
Tucson, AZ 85741-3118

Mailing address

4801 E Broadway Blvd Ste 251
Tucson, AZ 85711-3633
Phone (520) 327-0460

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
I20100119000216 AZ Practitioner - Physician Assistant 9032251723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Community Physicians PCGroup PAC ID 4587560552, 162 clinicians

Practice addresses (Care Compare)

2055 W Hospital Dr
Tucson, AZ 85704-7892
Phone (520) 547-5725

2155 W Orange Grove Rd
Tucson, AZ 85741-3118
Phone (520) 742-0414

2191 W Orange Grove Rd
Tucson, AZ 85741-3118
Phone (520) 547-3940

Hospital & facility affiliations

  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physician PC CurrentSince Nov 10, 2009 Accepting new patients

Locations

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

2155 W Orange Grove Rd
Tucson, AZ 85741
Phone (520) 742-0414

1925 W Orange Grove Rd
Ste 307
Tucson, AZ 85704
Phone (520) 742-0414

Interoperability endpoints

  • Direct secure messaging: nfavata18228@azacp.direct-ci.com

Organizations & group practices 2

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 1

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1790743409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 E BROADWAY BLVD STE 251",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113633",
            "telephone_number": "520-327-0460",
            "fax_number": "520-795-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413118",
            "telephone_number": "520-742-0414",
            "fax_number": "520-742-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVATA",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.