Organization Active NPI

Mesquite Pediatrics, PC

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1831202878
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24492 Issued in AZ
Legal business name
MESQUITE PEDIATRICS, PC
Practice address
2350 N Kibler PL
Suite 1
Tucson, AZ 85712-2100
Phone
(520) 648-5437
Fax
(520) 648-5438
NPI assigned
Aug 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey M Couchman, MDNPI 1982687455
Title
VP
Phone
(520) 648-5437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 24492 AZ Primary

Addresses

Primary practice location

2350 N Kibler PL
Suite 1
Tucson, AZ 85712-2100

Mailing address

PO Box 43100
Tucson, AZ 85733-3100
Phone (520) 722-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210324001782 AZ Part B Supplier - Clinic/Group Practice 2466478326 Receives reassigned benefits from 3 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

2350 N Kibler Pl
Tucson, AZ 85712
Phone (520) 327-6874

2350 N Kibler Pl
Ste 1
Tucson, AZ 85712
Phone (520) 648-5437

5983 E Grant Rd
Ste 105
Tucson, AZ 85712
Phone (520) 207-8884

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831202878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857333100",
            "telephone_number": "520-722-3777",
            "fax_number": "520-296-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N KIBLER PL",
            "address_2": "SUITE 1",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122100",
            "telephone_number": "520-648-5437",
            "fax_number": "520-648-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESQUITE PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUCHMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "520-648-5437",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "24492",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.