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CARONDELET MEDICAL GROUP, INC
NPI 1215974951
Family Medicine in Nogales, AZ

Active since June 01, 2006CLIA 03D2224255 · Waiver
1209 W. TARGET RANGE RD., NOGALES, AZ 85621(520) 287-4747(520) 285-3135 Get Directions Write a Review

NPPES record last updated: February 22, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Carondelet Medical Group, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARONDELET MEDICAL GROUP, INC (NPI 1215974951) is a healthcare organization registered as a family medicine in Nogales, Arizona and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through May 11, 2027 and lists Deb S Mohesky, Evp/cfo, as its authorized official.

NPPES Registry Identity

NPI1215974951
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCARONDELET MEDICAL GROUP, INC
Location Address1209 W. TARGET RANGE RD.Nogales, AZ 85621
Mailing Address2202 N. Forbes Blvd.Tucson, AZ 85745 · (520) 872-7536 · Fax (520) 872-7929
Phone(520) 287-4747
Fax(520) 285-3135
Organization SubpartNo
Authorized OfficialDeb S MoheskyEvp/cfo · (520) 872-7745
Enumeration DateJune 1, 2006
Last NPPES UpdateFebruary 22, 2012
✔ NPI 1215974951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedPodiatrist · Foot SurgeryTaxonomy 213ES0131X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
1209 W. TARGET RANGE RD., Nogales, AZ 85621
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Other Identifiers 1

Medicare ID-Type Unspecified28678

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2224255

Carondelet Medical Group St Mary's · Tucson, AZ
Active · expires May 11, 2027
CLIA Number03D2224255
Laboratory TypePractitioner Other
Certificate Effective DateMay 12, 2025
Certificate Expiration DateMay 11, 2027
Laboratory DirectorMohammad Reza Habibzadeh
Laboratory Phone(520) 533-5208
Laboratory LocationCarondelet Medical Group St Mary's1707 W St Mary's Rd Ste 101, Tucson, AZ 85745
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carondelet Medical Group, Inc's NPI number?

The NPI number for Carondelet Medical Group, Inc is 1215974951. It was assigned to this organization in the NPPES registry on June 1, 2006.

Where is Carondelet Medical Group, Inc located?

Carondelet Medical Group, Inc is located at 1209 W. Target Range Rd., Nogales, AZ 85621. The listed phone number is (520) 287-4747.

What is Carondelet Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Carondelet Medical Group, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2224255) is associated with this NPI, valid through May 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Carondelet Medical Group, Inc was last updated on February 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.