Individual provider Active NPI

Rommel Paulo Mesola, M.D.

  • Adult Medicine Physician
  • Buckeye, AZ
National Provider Identifier
1104979269
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
50495 Issued in AZ
Practice address
20751 W Market St
Buckeye, AZ 85396-7893
Phone
(623) 463-5000
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 50495 AZ Primary

Addresses

Primary practice location

20751 W Market St
Buckeye, AZ 85396-7893

Mailing address

20751 W Market St
Buckeye, AZ 85396-7893
Phone (623) 463-5000

Other identifiers 1

IdentifierTypeStateIssuer
8466559MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203001382 AZ Practitioner - Family Practice 8426156993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

20751 W Market St
Buckeye, AZ 85396-7893
Phone (623) 463-5000

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Jun 1, 2024 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Feb 7, 2025 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Jun 1, 2024 Accepting new patients
Christopher Stalberg, MD, PLLC CurrentSince Feb 25, 2024 Accepting new patients

Locations

20751 W Market St
Buckeye, AZ 85396
Phone (623) 463-5000

2001 N 4th St
Flagstaff, AZ 86004
Phone (928) 526-5020

1800 N Civic Sq
Ste 200
Goodyear, AZ 85395
Phone (623) 465-6506

1800 N Civic Sq
Ste 220
Goodyear, AZ 85395
Phone (623) 465-6506

4860 N Litchfield Rd
Ste 102
Litchfield Park, AZ 85340
Phone (602) 774-1695

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

21300 N John Wayne Pkwy
Ste 123
Maricopa, AZ 85139
Phone (520) 494-7778

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

14418 W Meeker Blvd
Ste 210
Sun City West, AZ 85375
Phone (623) 544-8400

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

13995 W Statler Blvd
Bldg 1
Surprise, AZ 85374
Phone (623) 478-3100

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1104979269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20751 W MARKET ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853967893",
            "telephone_number": "623-463-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20751 W MARKET ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853967893",
            "telephone_number": "623-463-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESOLA",
        "first_name": "ROMMEL",
        "middle_name": "PAULO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AZ",
            "license": "50495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8466559",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

Verify at the official NPI Registry.