MEDIFAST TUCSON COM INCORPORATED (NPI# 1073970133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073970133 |
| Entity Type | Organization |
| Organization Name | MEDIFAST TUCSON COM INCORPORATED |
| Other Organization Name | BARD T. MANNY, MD. |
| Practice Address |
5350 E Erickson Dr Tucson AZ 85712-2822 |
| Mailing Address |
Po Box 14377 Tucson AZ 85732-4377 |
| Practice Telephone | 5207332250 |
| Practice Fax Number | 5207332270 |
| Mailing Telephone | 5207332250 |
| Mailing Fax Number | 5207332270 |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-01-21 |
| Authorized Official Name | BRAD T MANNY (PRESIDENT) |
| Authorized Official Telephone | 5207332250 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bard T. Manny, MD. | Doing Business As Name - Organization |
| Street Address |
5350 E ERICKSON DR |
| City | TUCSON |
| State | AZ |
| Zip Code | 85712-2822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609878750 | Allan Barry Aven | Family Medicine | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2005-06-01 |
| 1033642780 | Qol Surgery Center LLC | Clinic/Center | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2017-04-10 |
| 1922455260 | Michelle S Lind | Registered Nurse | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2016-05-17 |
| 1659549319 | Quality of Life Medical & Research Center, LLC | Clinic/Center | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2008-02-15 |
| 1891987442 | Allan B Aven Md Sc | Family Medicine | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2007-08-16 |
| 1558589523 | Richard Gerhauser | Preventive Medicine | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2007-04-23 |
| 1356464226 | Sandra Joan Layman | Nurse Practitioner | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2007-04-07 |
| 1679637342 | John William Mcgettigan Jr. | Family Medicine | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2006-12-20 |
| 1508824855 | Quality of Life Medical Centers, LLC | Clinic/Center | 5350 E Erickson Dr, Tucson, AZ 85712-2822 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104950 | Nancy Rae Klug | Registered Nurse | 2380 N Ferguson Ave., Tucson, AZ 85712 | 2020-08-12 |
| 1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
| 1063031953 | Mehera Tiffanie Hormuz | Student in an Organized Health Care Education/Training Program | 5301 E. Grant Rd., Tucson, AZ 85712 | 2020-04-10 |
| 1770133282 | Elizabeth Nadeschzda Lowell | Nurse Practitioner | 4881 E Grant Road, Suite 101, Tucson, AZ 85712 | 2019-09-17 |
| 1174185649 | Pisa Asc Holdco LLC | Clinic/Center | 4741 E Camp Lowell Drive, Tucson, AZ 85712 | 2019-07-03 |
| 1548821838 | Painted Sky Healthcare, Inc. | Hospice Care, Community Based | 2980 N Swan Rd Ste 222, Tucson, AZ 85712 | 2019-06-26 |
| 1558925644 | Helen Jane Lyall | Registered Nurse | Tucson Medical Centre, 5301 E Grant Road, Tucson, AZ 85712 | 2019-04-24 |
| 1760953541 | Anna Marissa Ramirez | Nurse Practitioner | 5170 E Glenn St Ste 160, Tucson, AZ 85712 | 2018-12-05 |
| 1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
| 1003322926 | Millennium Acupuncture | Acupuncturist | 6161 E Pima St Tucson Az 85712, Apt 2074, Tucson, AZ 85712 | 2017-12-15 |
| Find all providers in zip 85712 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750675864 | Efrain Israel Cubillo Iv | Anesthesiology | 4582 N 1st Ave Ste 170, Tucson, AZ 85718-8607 | 2011-06-06 |
| 1861575078 | Pain Institute of Southern Arizona Pisa PC | Anesthesiology | 4582 N First Ave, Ste 170, Tucson, AZ 85718-8607 | 2006-10-23 |
| 1902893399 | Bennet E Davis | Anesthesiology | 39580 S Lago Del Oro Pkwy, Tucson, AZ 85739-1091 | 2005-09-30 |
| 1033116611 | Randall S. Prust | Anesthesiology | 4747 E Camp Lowell Dr, Tucson, AZ 85712-1256 | 2005-06-28 |
| 1891791653 | Robert J. Berens | Anesthesiology | 5355 E Erickson Dr, Tucson, AZ 85712-2826 | 2005-06-24 |
| 1265438220 | Khushvant Bhola | Anesthesiology | 4745 E Camp Lowell Dr, Tucson, AZ 85712-1256 | 2005-06-23 |
| 1467089300 | Sandman Anesthesia Consultants PC | Anesthesiology | 717 S Alvernon Way, Tucson, AZ 85711-5351 | 2020-03-23 |
| 1619407533 | Pain Institute of Southern Arizona Pisa PC | Anesthesiology | 4881 E Grant Rd Ste 101, Tucson, AZ 85712-2704 | 2017-06-13 |
| 1295148856 | Tucson Pain Institute PC | Anesthesiology | 6252 E Grant Rd, Suite150, Tucson, AZ 85712-5803 | 2014-06-11 |
| 1154694552 | Northwest Pain Management Pllc | Anesthesiology | 7225 N Mona Lisa Rd Ste 100a, Tucson, AZ 85741-4528 | 2012-02-15 |
| 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.