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EAST TUCSON IM & GERIATRICS, INC
NPI 1619968419
Clinic/Center - Primary Care in Tucson, AZ

Active since October 31, 2005CLIA 03D1085555 · Waiver
6556 E CARONDELET DR, TUCSON, AZ 85710(520) 296-8733(520) 296-8734 Get Directions Write a Review

NPPES record last updated: November 29, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About East Tucson Im & Geriatrics, Inc NPPES

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

EAST TUCSON IM & GERIATRICS, INC (NPI 1619968419) is a healthcare organization registered as a primary care in Tucson, Arizona and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through June 19, 2028 and lists Ramakrishnan Subbureddiar, President, as its authorized official.

NPPES Registry Identity

NPI1619968419
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEAST TUCSON IM & GERIATRICS, INC
Location Address6556 E CARONDELET DRTucson, AZ 85710-2117
Mailing Address6556 E Carondelet DrTucson, AZ 85710-2117 · (520) 296-8733 · Fax (520) 296-8734
Phone(520) 296-8733
Fax(520) 296-8734
Organization SubpartYes
Authorized OfficialRamakrishnan SubbureddiarPresident · (520) 296-8733
Enumeration DateOctober 31, 2005
Last NPPES UpdateNovember 29, 2007
✔ NPI 1619968419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in AZ · 30466
6556 E CARONDELET DR, Tucson, AZ 85710
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

East Tucson Im & Geriatrics, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to East Tucson Im & Geriatrics, Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ramakrishnan Subbureddiar, MD
Internal Medicine
NPI 1326016221
6556 E CARONDELET DR
Tucson, AZ 85710
(520) 296-8733
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 03D1085555

East Tucson Im + Geriatrics Inc · Tucson, AZ
Active · expires Jun 19, 2028
CLIA Number03D1085555
Laboratory TypePhysician Office
Certificate Effective DateJune 20, 2026
Certificate Expiration DateJune 19, 2028
Laboratory DirectorRam Subbureddiar, MD
Laboratory Phone(520) 296-8733
Laboratory LocationEast Tucson Im + Geriatrics Inc6556 E Carondelet Drive, Tucson, AZ 85710
CLIA data matches this NPI record on: Address Name Phone
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 East Tucson Im & Geriatrics, Inc's NPI number?

The NPI number for East Tucson Im & Geriatrics, Inc is 1619968419. It was assigned to this organization in the NPPES registry on October 31, 2005.

Where is East Tucson Im & Geriatrics, Inc located?

East Tucson Im & Geriatrics, Inc is located at 6556 E Carondelet Dr, Tucson, AZ 85710. The listed phone number is (520) 296-8733.

What is East Tucson Im & Geriatrics, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is East Tucson Im & Geriatrics, Inc enrolled in Medicare?

Yes. East Tucson Im & Geriatrics, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Tucson Im & Geriatrics, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to East Tucson Im & Geriatrics, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does East Tucson Im & Geriatrics, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D1085555) is associated with this NPI, valid through June 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Tucson Im & Geriatrics, Inc was last updated on November 29, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.