Active NPI
Richard W Trepeta, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
National Provider Identifier
1093780561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 16208
- Practice address
- 350 W Thomas Rd
Phoenix, AZ 85013-4409 - Phone
- (602) 263-9007
- NPI assigned
- Feb 20, 2006
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 16208 | AZ | Primary |
Addresses
Primary practice location
350 W Thomas Rd
Phoenix, AZ 85013-4409
Mailing address
PO Box 42210
Phoenix, AZ 85080-2210
Phone (623) 266-7770
Other practice location 1
14502 W Meeker Blvd
Sun City West, AZ 85375-5282
Phone (602) 685-5211
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1Z7112 | Other | AZ | HEALTH NET AZ-SUN CITY PA |
| AZ0828960 | Other | AZ | BCBSAZ-SUN CITY PATH |
| 111279 | Medicaid | AZ | |
| AZ0182900 | Other | AZ | BCBSAZ-PATH ASSOC |
| AX4478 | Other | AZ | HEALTH NET AZ-PATH ASSOC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16208 | AZ | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1093780561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 42210",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850802210",
"telephone_number": "623-266-7770",
"fax_number": "623-322-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 W THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134409",
"telephone_number": "602-263-9007"
}
],
"practiceLocations": [
{
"address_1": "14502 W Meeker Blvd",
"address_purpose": "LOCATION",
"city": "Sun City West",
"state": "AZ",
"postal_code": "853755282",
"country_code": "US",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TREPETA",
"first_name": "RICHARD",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-20",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AZ",
"license": "16208",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET AZ-SUN CITY PA",
"identifier": "1Z7112",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSAZ-SUN CITY PATH",
"identifier": "AZ0828960",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111279",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSAZ-PATH ASSOC",
"identifier": "AZ0182900",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET AZ-PATH ASSOC",
"identifier": "AX4478",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.