Andrew Peckham, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

234410 Issued in AZ

Practice address

2424 N Wyatt Dr Ste 100
Tucson, AZ 85712-6119

Phone

(520) 324-8621

Fax

(520) 324-3935

NPI assigned

Dec 14, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Allied Physicians LLCGroup PAC ID 7618972514, 120 clinicians

TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment Care Compare group NPD
• Northwest Allied Physicians LLC

  • General Practice Physician
  • Tucson, AZ
  • NPI 1003833179
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1851637128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31235",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511235",
            "telephone_number": "520-324-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 N WYATT DR STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126119",
            "telephone_number": "520-324-8621",
            "fax_number": "520-324-3935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5433 E 8th St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857113108",
            "country_code": "US",
            "telephone_number": "520-940-4483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 E Grant Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122805",
            "country_code": "US",
            "telephone_number": "520-324-8621",
            "fax_number": "520-324-3935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "ANDREW",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-14",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "AZ",
            "license": "RN148598",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "234410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sultana Pecherskaya, LAC
• Courtney Jeanne Peck, M.S.-CCC
• Denny L Peck, PH.D.
• Jodi Peck, LMT
• Michael Lawrence Peck, FNP-C
• Donald Lee Peckinpaugh, HAD5930
• Sean Pecoraro, DO, MPH
• Julia Peddy, LPC
• David Andrew Pedersen, MD
• Pediatric Communication Services

• Acute Care Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.