Individual provider Active NPI

Joseph D. Shrager, M.D.

  • Dermatology Physician
  • Tucson, AZ
National Provider Identifier
1912905589
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
41219 Issued in AZ
Practice address
3838 N Campbell Ave
Tucson, AZ 85719-1478
Phone
(520) 694-2873
Fax
(520) 694-1820
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD 006191-E PA
Dermatology Physician 207N00000X 41219 AZ Primary

Addresses

Primary practice location

3838 N Campbell Ave
Tucson, AZ 85719-1478

Mailing address

2701 E Elvira Rd
Tucson, AZ 85756-7124
Phone (520) 874-3500

Other identifiers 1

IdentifierTypeStateIssuer
399983MedicaidAZ

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 006191-EPAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dermatology of Pennsylvania, PC Dermatology Past Accepting new patients
Banner-University Medical Group Dermatology 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1912905589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857567124",
            "telephone_number": "520-874-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191478",
            "telephone_number": "520-694-2873",
            "fax_number": "520-694-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRAGER",
        "first_name": "JOSEPH",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD 006191-E",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "41219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399983",
            "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 Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.