Individual provider Active NPI

Luis Alberto Cueva Jr., DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Tucson, AZ
National Provider Identifier
1801880760
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
D4543 Issued in AZ
Practice address
850 N Kolb Rd
Tucson, AZ 85710-1333
Phone
(520) 298-9186
Fax
(520) 298-9608
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X D4543 AZ Primary

Addresses

Primary practice location

850 N Kolb Rd
Tucson, AZ 85710-1333

Mailing address

850 N Kolb Rd
Tucson, AZ 85710-1333
Phone (520) 298-9186

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000611 AZ Practitioner - Oral Surgery 0042295230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

850 N Kolb Rd
Tucson, AZ 85710-1333
Phone (520) 298-9186

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4543AZMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
TMJ Disorders Orofacial Pain Center Oral & Maxillofacial Surgery CurrentSince Jan 1, 2003 Accepting new patients

Locations

850 N Kolb Rd
Tucson, AZ 85710
Phone (520) 257-3881

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1801880760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N KOLB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101333",
            "telephone_number": "520-298-9186",
            "fax_number": "520-298-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N KOLB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101333",
            "telephone_number": "520-298-9186",
            "fax_number": "520-298-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUEVA",
        "first_name": "LUIS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "D4543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.