Individual provider Active NPI

Cassandra Ballantyne, MD

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1851973192
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R78555 Issued in AZ
Practice address
4730 E Grant Rd
Tucson, AZ 85712-2703
Phone
(520) 290-0300
Fax
(520) 298-9230
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X R78555 AZ Primary

Addresses

Primary practice location

4730 E Grant Rd
Tucson, AZ 85712-2703

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

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
I20240827001603 AZ Practitioner - Internal Medicine 0143620625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Dakota School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greater Phoenix Collaborative Care PCGroup PAC ID 0941503304, 111 clinicians

Practice addresses (Care Compare)

4730 E Grant Rd
Tucson, AZ 85712-2703
Phone (702) 480-2550

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Tucson, AZ, CCN 037213
  • Dependable Home Health, Inc Home health agency, Tucson, AZ, CCN 037070
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Aug 1, 2024 Accepting new patients
Arizona Medical Services, PC Single Specialty PastSince Apr 28, 2005 Accepting new patients

Locations

695 S Pecan Tree Ln
Green Valley, AZ 85614
Phone (520) 625-8116

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

4730 E Grant Rd
Tucson, AZ 85712
Phone (520) 290-0300

1669 W Ina Rd
Ste 141
Tucson, AZ 85704
Phone (520) 795-6183

Interoperability endpoints

  • Direct secure messaging: cballantyne113323@westdirect.optum.com

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 6

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1851973192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203",
            "fax_number": "702-838-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122703",
            "telephone_number": "520-290-0300",
            "fax_number": "520-298-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLANTYNE",
        "first_name": "CASSANDRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R78555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.