Individual provider Active NPI

Jeremey William Gneck, MD

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1952965212
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
67082 Issued in AZ
Practice address
7490 S Camino de Oeste
Tucson, AZ 85746-9308
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Apr 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 67082 AZ Primary

Addresses

Primary practice location

7490 S Camino de Oeste
Tucson, AZ 85746-9308

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Other identifiers 1

IdentifierTypeStateIssuer
164767MedicaidAZ

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
I20221104000786 AZ Practitioner - Pediatric Medicine 8224363528 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jul 21, 2025 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Oct 1, 2022 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Oct 1, 2022 Accepting new patients
Banner-University Medical Group CurrentSince Jul 21, 2025 Accepting new patients
Banner-University Medical Group Family Medicine Current Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2167 W Orange Grove Rd
Tucson, AZ 85741
Phone (520) 544-7650

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

8290 S Houghton Rd
Ste 150
Tucson, AZ 85747
Phone (520) 694-1045

265 W Ina Rd
Tucson, AZ 85704
Phone (520) 694-8000

7490 S Camino de Oeste
Tucson, AZ 85746
Phone (520) 879-6039

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

Interoperability endpoints

  • Direct secure messaging: jgneck27919@elrio.direct.ci.com

Organizations & group practices 6

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1952965212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7490 S CAMINO DE OESTE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857469308",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNECK",
        "first_name": "JEREMEY",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "67082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164767",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.