Coronado Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23701 Issued in AZ

Legal business name

CORONADO INTERNAL MEDICINE PC

Practice address

6365 E Tanque Verde Rd
Suite 210
Tucson, AZ 85715-3830

Phone

(520) 885-2072

Fax

(520) 721-9464

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey S Mayer, MDNPI 1538253620

Title

President

Phone

(520) 885-2072

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Scott Mayer, MD

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1538253620
  Medicare reassignment NPD Authorized official
• Betty Jean Blangsted, NP-C

  • Nurse Practitioner
  • Tucson, AZ
  • NPI 1932613957
  Medicare reassignment NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1932293032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857333100",
            "telephone_number": "520-722-3777",
            "fax_number": "520-296-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6365 E TANQUE VERDE RD",
            "address_2": "SUITE 210",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153830",
            "telephone_number": "520-885-2072",
            "fax_number": "520-721-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONADO INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-885-2072",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "23701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Hospital of Southeast Arizona LLC
• Eric G Cornidez, M.D.
• Cybil Rae Corning, MD
• Elizabeth Corning, PH.D.
• James E Corning, D.D.S.
• Coronado Surgery Center LLC
• Jesus Coronado Jr., LPN
• Paulethe Coronado, RBT
• Violeta Coronado, LMT, MLDT
• Christine Denice Corral-Parsons, M.A.,L.A.S.A.C.

• 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 May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.