Active NPI
Robert N Gavlak, M.D.
- Occupational Medicine Physician
- Tucson, AZ
National Provider Identifier
1881719615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 13554
- Practice address
- 4600 S Park Avenue
Suite 3-5
Tucson, AZ 85714 - Phone
- (615) 778-4066
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 13554 | AZ | Primary |
Addresses
Primary practice location
4600 S Park Avenue
Suite 3-5
Tucson, AZ 85714
Mailing address
5080 Spectrum Drive
Suite 1200 West Tower
Addison, TX 75001
Phone (800) 232-3550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282137 | Medicaid | AZ | |
| 300205 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13554 | AZ | MD | Occupational Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swea, P.C. | Past | Accepting new patients | |
| Emergency Room Associates Limited | Past | Accepting new patients | |
| Pinnacle Medicine Inc. | Past | Accepting new patients | |
| Nextcare Arizona LLC | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Tucson, AZ
- NPI 1770586869
-
dba Southwest Emergency Associates, P.C.
- Emergency Medicine Physician
- Tucson, AZ
- NPI 1407953573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1881719615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DRIVE",
"address_2": "SUITE 1200 WEST TOWER",
"city": "ADDISON",
"state": "TX",
"postal_code": "75001",
"telephone_number": "800-232-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 S PARK AVENUE",
"address_2": "SUITE 3-5",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85714",
"telephone_number": "615-778-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVLAK",
"first_name": "ROBERT",
"middle_name": "N",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "AZ",
"license": "13554",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "282137",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300205",
"state": "AZ"
}
],
"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 Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.