Individual provider Active NPI

Lori E Fantry, MD, MPH

  • Infectious Disease Physician
  • Tucson, AZ
National Provider Identifier
1821046277
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
52406 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-1544
Phone
(410) 328-9105
Fax
(410) 328-4430
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 52406 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-1544

Mailing address

P.O. Box 245039
1501 N. Campbell Ave.
Tucson, AZ 85722
Phone (520) 626-6887

Other identifiers 3

IdentifierTypeStateIssuer
4420540MedicaidDC
520948-01 & 02OtherMDBLUE CROSS/BLUE SHIELD
066631900MedicaidMD

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
I20160728002733 AZ Practitioner - Infectious Disease 2668667643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1985
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)

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

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 CurrentSince Jul 18, 2016 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Jul 18, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

1501 N Campbell Ave
#245575
Tucson, AZ 85724

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

3838 N Campbell Ave
#2
Tucson, AZ 85719

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

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

1625 N Campbell Ave
Tucson, AZ 85719

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

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 2

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821046277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 245039",
            "address_2": "1501 N. CAMPBELL AVE.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85722",
            "telephone_number": "520-626-6887",
            "fax_number": "520-626-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857241544",
            "telephone_number": "410-328-9105",
            "fax_number": "410-328-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTRY",
        "first_name": "LORI",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "52406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4420540",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "520948-01 & 02",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066631900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.