Individual provider Active NPI

Tracy Baser-Decker, MD

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1790771442
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25513 Issued in AZ
Practice address
1925 W Orange Grove Rd Ste 302
Tucson, AZ 85704-1152
Phone
(520) 797-3888
Fax
(520) 797-2196
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25513 AZ Primary

Addresses

Primary practice location

1925 W Orange Grove Rd Ste 302
Tucson, AZ 85704-1152

Mailing address

1925 W Orange Grove Rd Ste 302
Tucson, AZ 85704-1152
Phone (520) 797-3888

Other identifiers 1

IdentifierTypeStateIssuer
497562MedicaidAZ

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25513AZMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1790771442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 W ORANGE GROVE RD STE 302",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041152",
            "telephone_number": "520-797-3888",
            "fax_number": "520-797-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 W ORANGE GROVE RD STE 302",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041152",
            "telephone_number": "520-797-3888",
            "fax_number": "520-797-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASER-DECKER",
        "first_name": "TRACY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "25513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497562",
            "state": "AZ"
        }
    ],
    "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 May 22, 2020; 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.