Individual provider Active NPI

Kevin Joseph Moynahan, MD

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1801419452
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
69481 Issued in AZ
Practice address
7901 E 22ND St
Tucson, AZ 85710-8509
Phone
(520) 694-8888
Fax
(520) 694-8466
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 69481 AZ Primary

Addresses

Primary practice location

7901 E 22ND St
Tucson, AZ 85710-8509

Mailing address

7901 E 22ND St
Tucson, AZ 85710-8509
Phone (520) 694-8888

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
I20230612002356 AZ Practitioner - Internal Medicine 1557784626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arizona College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

7901 E 22ND St
Tucson, AZ 85710-8509
Phone (520) 694-5437

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Banner-University Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

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

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

7901 E 22nd St
Tucson, AZ 85710
Phone (520) 694-8400

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

Organizations & group practices 3

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 7

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": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1801419452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 E 22ND ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857108509",
            "telephone_number": "520-694-8888",
            "fax_number": "520-694-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 E 22ND ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857108509",
            "telephone_number": "520-694-8888",
            "fax_number": "520-694-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNAHAN",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "69481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.