Individual provider Active NPI

Matthew Joseph Prevost, MD

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1962290304
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R81747 Issued in AZ
Practice address
655 N Alvernon Way Ste 228
Tucson, AZ 85711-1853
Phone
(520) 626-2551
Fax
(520) 694-1640
NPI assigned
Apr 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R81747 AZ Primary

Addresses

Primary practice location

655 N Alvernon Way Ste 228
Tucson, AZ 85711-1853

Mailing address

1847 S Math Quiz Dr
Tucson, AZ 85711-0007
Phone (906) 362-1812

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
I20250711003691 AZ Order and Referring Only - Family PracticePractitioner - Family Practice 8022523745

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R81747AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1745625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1962290304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 S MATH QUIZ DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857110007",
            "telephone_number": "906-362-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N ALVERNON WAY STE 228",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111853",
            "telephone_number": "520-626-2551",
            "fax_number": "520-694-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVOST",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-26",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R81747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.