Organization Active NPI

RSG Healthcare, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1336825868
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RSG HEALTHCARE, PLLC
Practice address
11209 N Tatum Blvd Ste B185
Phoenix, AZ 85028-3091
Phone
(602) 222-3333
Fax
(877) 991-7646
NPI assigned
Jun 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Authorized official

Name
Dr. Randy Steven Gelow II, MDNPI 1568755130
Title
Owner & Ceo
Phone
(602) 669-2585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11209 N Tatum Blvd Ste B185
Phoenix, AZ 85028-3091

Mailing address

PO Box 39675
Phoenix, AZ 85069-9675
Phone (602) 669-2585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240619000400 AZ Part B Supplier - Clinic/Group Practice 6204280845 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2287573RSG Healthcare, PLLC11209 N Tatum Blvd Ste B185, Phoenix, AZ 85028Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory

Locations

11209 N Tatum Blvd
#B185
Phoenix, AZ 85028
Phone (602) 669-2585

11209 N Tatum Blvd
Ste 185
Phoenix, AZ 85028
Phone (602) 669-2585

11209 N Tatum Blvd
Ste B185
Phoenix, AZ 85028
Phone (602) 669-2585

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/29480/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713657600000",
    "number": "1336825868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39675",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850699675",
            "telephone_number": "602-669-2585",
            "fax_number": "602-669-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD STE B185",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283091",
            "telephone_number": "602-222-3333",
            "fax_number": "877-991-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSG HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A",
        "authorized_official_last_name": "GELOW",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER & CEO",
        "authorized_official_telephone_number": "602-669-2585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.