Individual provider Active NPI

John Michael Robinson, PA-C

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1154883205
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7808 Issued in AZ
Practice address
2730 S Val Vista Dr Building 13
Ste 177
Gilbert, AZ 85295-1683
Phone
(480) 394-0200
Fax
(480) 394-0202
NPI assigned
Apr 5, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 7808 AZ Primary

Addresses

Primary practice location

2730 S Val Vista Dr Building 13
Ste 177
Gilbert, AZ 85295-1683

Mailing address

2730 S Val Vista Drive, Building 13
Suite 177
Gilbert, AZ 85295-1683
Phone (480) 394-0200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331002199 AZ Practitioner - Physician Assistant 6507295268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona State Urological Institute LLCGroup PAC ID 7719962000, 17 clinicians

Practice addresses (Care Compare)

2730 S Val Vista Dr
Suite 177
Gilbert, AZ 85295-1683
Phone (480) 394-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7808AZMDPhysician Assistant

Organizations & group practices 1

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 7

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1154883205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DRIVE, BUILDING 13",
            "address_2": "SUITE 177",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951683",
            "telephone_number": "480-394-0200",
            "fax_number": "480-394-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR BUILDING 13",
            "address_2": "STE 177",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951683",
            "telephone_number": "480-394-0200",
            "fax_number": "480-394-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.