CARONDELET MEDICAL GROUP INC (NPI# 1972834984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972834984 |
| Entity Type | Organization |
| Organization Name | CARONDELET MEDICAL GROUP INC |
| Practice Address |
630 N Alvernon Way Ste 251 Tucson AZ 85711-1879 |
| Mailing Address |
Po Box 29347 Phoenix AZ 85038-9347 |
| Practice Telephone | 5203193283 |
| Practice Fax Number | 5203193982 |
| Mailing Telephone | 5208727000 |
| Mailing Fax Number | 5208727969 |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-08-04 |
| Authorized Official Name | PAULA REGISTER (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 5208727076 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0585 | Podiatric Medicine & Surgery Service Providers | |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
647 | AZ | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0666 | AZ | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0546 | AZ | Podiatric Medicine & Surgery Service Providers |
| Street Address |
630 N ALVERNON WAY STE 251 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85711-1879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922090513 | Soungwon Bae | Pediatrics | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2005-08-18 |
| 1104303080 | Shaina Berman | Physician Assistant | 630 N Alvernon Way Ste 251, Tucson, AZ 85711 | 2018-07-24 |
| 1093258964 | Matthew Gilkey | Nurse Practitioner | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2016-11-28 |
| 1023564135 | Jessica Coffey | Nurse Practitioner | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2016-08-29 |
| 1851747166 | Christopher Taylor | Nurse Practitioner | 630 N Alvernon Way Ste 251, Tucson, AZ 85711 | 2016-05-05 |
| 1871851782 | Sukhampal Singh Sidhu | Internal Medicine | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2012-04-27 |
| 1124294756 | Winola Rachel Purushotham | Internal Medicine | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2008-05-04 |
| 1215159322 | Deepa Agarwal | Pediatrics | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959951 | Ridgeline Practice | Counselor | 4625 N Broadway, Suite 105, Tucson, AZ 85711 | 2020-07-20 |
| 1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1063060093 | Sharese Ann Bailey | Counselor | 300 S Craycroft Rd, Tucson, AZ 85711 | 2019-09-03 |
| 1467940015 | Jin Zhang | Ophthalmology | 655 N Alvernon Way Ste 204, Tucson, AZ 85711 | 2018-04-30 |
| 1447779525 | Catherine Butler Hobart | Pharmacist | 535 North Wilmont Road, Suite 101, Tucson, AZ 85711 | 2017-09-11 |
| 1689196420 | Cope Community Services, Inc. | Case Management | 924 N Alvernon Way, Tucson, AZ 85711 | 2017-07-13 |
| 1124561477 | Regina Maendler | Behavioral Analyst | 630 N. Craycroft Rd, Tucson, AZ 85711 | 2016-11-18 |
| 1881140184 | Elleda Linsmeyer | Speech-Language Pathologist | St. Joesph's Hosptial, 350 N. Wilmont Rd., Tucson, AZ 85711 | 2016-08-28 |
| 1962856260 | Csl-tucson, LLC | Assisted Living Facility | 1020 N. Woodland Avenue, Tucson, AZ 85711 | 2016-04-22 |
| Find all providers in zip 85711 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750803748 | Christopher Sullivan | Podiatrist | 6442 S. Speedway Blvd, Ste 102, Tucson, AZ 85710 | 2017-07-11 |
| 1801183744 | David Wayne Gooch | Podiatrist | 6565 E Carondelet Dr # 385, Tucson, AZ 85710-2117 | 2011-06-29 |
| 1235365685 | Andrea Renee Roemer | Podiatrist | 5600 W Placita Del Risco, Tucson, AZ 85745-9196 | 2009-05-29 |
| 1659514818 | Tara Fay Shirley | Podiatrist | 899 N Wilmot Road Ste E6, Tucson, AZ 85711-1714 | 2009-04-16 |
| 1386652444 | James F. Dancho | Podiatrist | 4629 S Almond St, Tucson, AZ 85730-4619 | 2006-08-04 |
| 1497786750 | Eric H Espensen | Podiatrist | 1500 N Campbell Ave, Room 4402, Tucson, AZ 85724-5872 | 2006-07-05 |
| 1821089624 | Bradley Whitaker | Podiatrist | 2163 W Orange Grove Rd, Tucson, AZ 85741-3118 | 2005-10-31 |
| 1104813237 | Glenn E. Nelson | Podiatrist | 2308 N Rosemont Blvd, Tucson, AZ 85712-2139 | 2005-10-04 |
| 1790207363 | Patrick Law | Podiatrist | 3601 S 6th Ave, Tucson, AZ 85723 | 2017-07-14 |
| 1023541455 | Parth Patel | Podiatrist | 2308 N Rosemont Blvd, Tucson, AZ 85712-2139 | 2017-04-03 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.