Individual provider Active NPI

Robert A Saretsky, D.O.

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
National Provider Identifier
1194722116
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1578 Issued in AZ
Practice address
6525 W Sack Dr
Suite 208
Glendale, AZ 85308-7104
Phone
(623) 566-2004
Fax
(623) 566-2060
NPI assigned
Jul 5, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 1578 AZ Primary

Addresses

Primary practice location

6525 W Sack Dr
Suite 208
Glendale, AZ 85308-7104

Mailing address

6525 W Sack Dr
Suite 208
Glendale, AZ 85308-7104
Phone (623) 566-2004

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
1578AZMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Obstetrics & Gynecology PC PastSince Nov 1, 2003 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1194722116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 W SACK DR",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087104",
            "telephone_number": "623-566-2004",
            "fax_number": "623-566-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 W SACK DR",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087104",
            "telephone_number": "623-566-2004",
            "fax_number": "623-566-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARETSKY",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2007-10-25",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "1578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.