Phillip John Dattilo, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

241 Issued in AZ

Practice address

1404 East Prince Road
Tucson Cardiology LTD
Tucson, AZ 85719

Phone

(520) 327-7494

Fax

(520) 327-7493

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine, Nuclear Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 1959

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Tucson Cardiology LTD

  • Nuclear Medicine Physician
  • Tucson, AZ
  • NPI 1801932744

  Internal Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1861545048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 EAST PRINCE ROAD",
            "address_2": "TUCSON CARDIOLOGY LTD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85719",
            "telephone_number": "520-327-7494",
            "fax_number": "520-327-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 EAST PRINCE ROAD",
            "address_2": "TUCSON CARDIOLOGY LTD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85719",
            "telephone_number": "520-327-7494",
            "fax_number": "520-327-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "PHILLIP",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "241",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "241",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "AZ",
            "license": "13",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228420",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anindita Das, MD
• Rama Sirisha Dasari, MD
• Alice C Dastrup, ARNP, CRNA
• Amber Dato, LPC
• Sanchari Datta, M.D.
• Tagg A Daugherty, PHARM.D
• Dafney Davare
• Soham U. Dave, DO
• Davenport & Davenport, PLLC
• David Davenport, D.D.S.

• Internal Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.