Active NPI
Robert Joseph Ibarra, FNP-C
- Family Nurse Practitioner
- Mesa, AZ
National Provider Identifier
1114728391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 283519
- Practice address
- 1148 W Baseline Rd
Mesa, AZ 85210-5971 - Phone
- (480) 559-3149
- NPI assigned
- Mar 22, 2025
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 283519 | AZ | Primary |
Addresses
Primary practice location
1148 W Baseline Rd
Mesa, AZ 85210-5971
Mailing address
3719 E Inverness Ave Unit 6
Mesa, AZ 85206-3802
Phone (406) 860-8861
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective May 6, 2025 through May 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 283519 | AZ | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1114728391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3719 E INVERNESS AVE UNIT 6",
"city": "MESA",
"state": "AZ",
"postal_code": "852063802",
"telephone_number": "406-860-8861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1148 W BASELINE RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852105971",
"telephone_number": "480-559-3149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARRA",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-22",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "283519",
"primary": true
}
],
"identifiers": [],
"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 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.