Individual provider Active NPI

Diana C Rauckman, NP

  • Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1902885262
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP2307 Issued in AZ
Practice address
1460 W Valencia Rd
Tucson, AZ 85746-6001
Phone
(520) 573-0966
Fax
(520) 573-3930
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP2307 AZ Primary

Addresses

Primary practice location

1460 W Valencia Rd
Tucson, AZ 85746-6001

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

Other practice location 1

4730 E Grant Rd
Tucson, AZ 85712-2703
Phone (520) 290-0300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060206000525 AZ Practitioner - Nurse Practitioner 5890752232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Phoenix Collaborative Care PCGroup PAC ID 0941503304, 111 clinicians

Practice addresses (Care Compare)

1460 W Valencia Rd
Tucson, AZ 85746-6001
Phone (520) 573-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP2307AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Dec 16, 2016 Accepting new patients
Northwest Allied Physicians LLC CurrentSince Jun 1, 2016 Accepting new patients
Northwest Allied Physicians, LLC CurrentSince Jun 1, 2016 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Dec 16, 2016 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

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

1313 W Magee Rd
Tucson, AZ 85704
Phone (520) 797-2600

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

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

1669 W Ina Rd
Ste 101
Tucson, AZ 85704
Phone (520) 573-0966

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

Interoperability endpoints

  • Direct secure messaging: drauckman114307@westdirect.optum.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1902885262",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 W VALENCIA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466001",
            "telephone_number": "520-573-0966",
            "fax_number": "520-573-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4730 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122703",
            "country_code": "US",
            "telephone_number": "520-290-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAUCKMAN",
        "first_name": "DIANA",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.