Active NPI
Robert Elk, M.D.
- Internal Medicine Physician
- Mesa, AZ
National Provider Identifier
1083643514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 13116
- Practice address
- 1705 W Main St
Mesa, AZ 85201-6920 - Phone
- (877) 809-5092
- Fax
- (480) 491-6239
- NPI assigned
- Jun 30, 2006
- Last updated
- Apr 11, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 13116 | AZ | Primary |
Addresses
Primary practice location
1705 W Main St
Mesa, AZ 85201-6920
Mailing address
9520 W Palm LN
Suite 200
Phoenix, AZ 85037-4403
Phone (623) 583-3001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206096 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1083643514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9520 W PALM LN",
"address_2": "SUITE 200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850374403",
"telephone_number": "623-583-3001",
"fax_number": "623-583-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 W MAIN ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852016920",
"telephone_number": "877-809-5092",
"fax_number": "480-491-6239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELK",
"first_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "13116",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206096",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.