Individual provider Active NPI

Randall A Brown, M.D.

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1881681393
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22563 Issued in AZ
Practice address
265 W Ina Rd
Tucson, AZ 85704-6204
Phone
(520) 694-8100
Fax
(520) 694-8194
NPI assigned
Sep 29, 2005
Last updated
Dec 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22563 AZ Primary

Addresses

Primary practice location

265 W Ina Rd
Tucson, AZ 85704-6204

Mailing address

265 W Ina Rd
Tucson, AZ 85704-6204
Phone (520) 694-8100

Other identifiers 1

IdentifierTypeStateIssuer
775463MedicaidAZ

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
I20220310002982 AZ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7810998143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22563AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner -- University Medical Center Tucson Campus LLC Past Accepting new patients
Hospitalists of Arizona, Inc Internal Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1881681393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 W INA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857046204",
            "telephone_number": "520-694-8100",
            "fax_number": "520-694-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 W INA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857046204",
            "telephone_number": "520-694-8100",
            "fax_number": "520-694-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RANDALL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "22563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "775463",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.