Individual provider Active NPI

Jason M Humphrey, P.A.-C.

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1972504561
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2259 Issued in AZ
Practice address
2611 N Vuelta Vista Antigua
Tucson, AZ 85715-3620
Phone
(520) 289-5411
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2259 AZ Primary
Medical Physician Assistant 363AM0700X 2259 AZ
Surgical Physician Assistant 363AS0400X 2259 AZ

Addresses

Primary practice location

2611 N Vuelta Vista Antigua
Tucson, AZ 85715-3620

Mailing address

2611 N Vuelta Vista Antigua
Tucson, AZ 85715-3620
Phone (520) 289-5411

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061101000004 AZ Practitioner - Physician Assistant 2961409149 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2259AZMDMedical Physician Assistant

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1972504561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 N VUELTA VISTA ANTIGUA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153620",
            "telephone_number": "520-289-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 N VUELTA VISTA ANTIGUA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153620",
            "telephone_number": "520-289-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2259",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2259",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "2259",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.