Individual provider Active NPI

Randall L Bennett, M.D.

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1962402800
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23428 Issued in AZ
Practice address
350 N Wilmot Rd
Tucson, AZ 85711-2602
Phone
(520) 872-7130
NPI assigned
Jul 21, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23428 AZ Primary

Addresses

Primary practice location

350 N Wilmot Rd
Tucson, AZ 85711-2602

Mailing address

2202 N Forbes Blvd
Tucson, AZ 85745-1412
Phone (520) 872-7130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100407000367 AZ Practitioner - Emergency Medicine 7517944283 Reassigns benefits to 3 organizations
I20190822002377 TX Practitioner - Emergency Medicine 7517944283 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Arizona Inc Emergency Medicine Current Accepting new patients
Bisbee Hospital Association CurrentSince Jan 1, 2018 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
Nes Arizona Inc Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Benson Hospital Corporation CurrentSince Feb 7, 2015 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Jul 21, 2019 Accepting new patients
Benson Hospital Corporation CurrentSince Feb 7, 2015 Accepting new patients
Bisbee Hospital Association Current Accepting new patients
Copper Queen Medical Associates Douglas CurrentSince Jan 1, 2018 Accepting new patients
Emergency Room Associates Past Accepting new patients
Emergency Room Associates Limited Emergency Medicine Past Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

7300 State Highway 121
Ste 374
McKinney, TX 75070

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962402800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N FORBES BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451412",
            "telephone_number": "520-872-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112602",
            "telephone_number": "520-872-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RANDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "23428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.