KAYVAAN M MORTAZAVI (NPI# 1124265285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124265285 |
| Entity Type | Individual |
| Full Name | KAYVAAN M MORTAZAVI |
| Credential | MD |
| Practice Address |
6567 E Carondelet Dr Suite 555 Tucson AZ 85710-6152 |
| Mailing Address |
2202 N Forbes Blvd Tucson AZ 85745-1412 |
| Practice Telephone | 5208853588 |
| Practice Fax Number | 5202903958 |
| Mailing Telephone | 5208853588 |
| Mailing Fax Number | 5202903930 |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2011-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 42417 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 524573 | 05 |
| Street Address |
6567 E CARONDELET DR SUITE 555 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85710-6152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912902800 | Fraser Richards | Specialist | 6567 E Carondelet Dr, Ste 225, Tucson, AZ 85710-6152 | 2005-06-16 |
| 1225490683 | Alisha Severson | Audiologist | 6567 E Carondelet Dr, Tucson, AZ 85710-6152 | 2016-03-24 |
| 1386002350 | Wren Winston | Nurse Practitioner | 6567 E Carondelet Dr, Ste 215, Tucson, AZ 85710-6152 | 2016-02-05 |
| 1457733206 | Sarah Laszok | Audiologist | 6567 E Carondelet Dr, Suite 515, Tucson, AZ 85710-6152 | 2015-06-28 |
| 1174941439 | Timothy Hoskins Obgyn | Obstetrics & Gynecology | 6567 E Carondelet Dr, Suite 445, Tucson, AZ 85710-6152 | 2014-04-03 |
| 1689003956 | Ashley Nicole Ryan | Physician Assistant | 6567 E Carondelet Dr, Suite 305, Tucson, AZ 85710-6152 | 2013-11-06 |
| 1306274790 | Western Neurosurgery. Ltd. | Physician Assistant | 6567 E Carondelet Dr, Suite 305, Tucson, AZ 85710-6152 | 2013-10-22 |
| 1538405386 | Chelsea Mcnally | Physician Assistant | 6567 E Carondelet Dr, Suite 305, Tucson, AZ 85710-6152 | 2012-12-26 |
| 1447527817 | Sitara Kommareddi Md Pllc | Surgery | 6567 E Carondelet Dr, Suite 435, Tucson, AZ 85710-6152 | 2011-11-29 |
| 1205167277 | Timothy J Knoll | Physician Assistant | 6567 E Carondelet Dr, Suite 415, Tucson, AZ 85710-6152 | 2010-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689220691 | Elidia Beas Newbold | Technician | 9122 E. Calle Maria, Tuscon, AZ 85710 | 2019-08-15 |
| 1669934014 | Pain Institute of Southern Arizona (pisa), PC | Pain Medicine | 7140 E Rosewood Street, Suite 110, Tucson, AZ 85710 | 2019-04-04 |
| 1316438351 | Life Aligned Regenerative Medical Center LLC | General Practice | 7920 E Broadway Blvd, Suite 106, Tuscon, AZ 85710 | 2018-05-25 |
| 1497264253 | Beverly Capili | Nurse Practitioner | 6622 East Carondelet Drive, Tucson, AZ 85710 | 2017-09-25 |
| 1629590120 | Linsey Nicole Tomaro | Physician Assistant | 6303 E. Broadway Blvd., Suite 161, Tucson, AZ 85710 | 2017-07-17 |
| 1750803748 | Christopher Sullivan | Podiatrist | 6442 S. Speedway Blvd, Ste 102, Tucson, AZ 85710 | 2017-07-11 |
| 1346762713 | Friday Sika | Respite Care | 8251 E. Kenyon Dr., Tucson, AZ 85710 | 2017-07-07 |
| 1821536228 | Southern Arizona Urgent Care, LLC | Clinic/Center | 6303 E. Broadway Blvd, 161, Tucson, AZ 85710 | 2017-02-06 |
| 1659727816 | Mwangaza Residential Care LLC | Community Based Residential Treatment Facility, Mental Illness | 8421 E. Colette St, Tucson, AZ 85710 | 2016-05-06 |
| 1124494240 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 921 S Prudence Rd, Tucson, AZ 85710 | 2015-08-12 |
| Find all providers in zip 85710 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609493402 | Old Pueblo Mobile Medicine LLC | Family Medicine | 9721 E Colette St, Tucson, AZ 85748-2756 | 2020-06-29 |
| 1023641792 | Amy Fitzgerald | Family Medicine | 2442 E Blue Diamond Dr, Tucson, AZ 85718-6691 | 2020-02-20 |
| 1578194866 | Keto Consults LLC | Family Medicine | 7469 E Broadway Blvd Ste A, Tucson, AZ 85710-1487 | 2020-01-27 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1215440326 | Maryelizabeth Hunter | Family Medicine | 6890 E Sunrise Dr Ste 120-176, Tucson, AZ 85750-0738 | 2017-11-10 |
| 1164963591 | Shohei Sowid-shima | Family Medicine | 6860 E Sunrise Dr Ste 100, Tucson, AZ 85750-0733 | 2017-03-18 |
| 1588024178 | Norma A. Price | Family Medicine | 602 W Ajo Way, Tucson, AZ 85713-6046 | 2016-02-25 |
| 1801279617 | Mitul Vinodkumar Mehta | Family Medicine | 2355 N Wyatt Dr Ste 101, Tucson, AZ 85712-2120 | 2015-06-30 |
| 1649652280 | Angela Suhale Puthenveetil | Family Medicine | 8020 N Cortaro Rd Ste 150, Tucson, AZ 85743-8305 | 2015-06-19 |
| 1366821068 | Renewed Medical Health | Family Medicine | 3382 E Speedway Blvd, Tucson, AZ 85716-3936 | 2015-05-27 |
| 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.