Active NPI
Glen N Robison, DPM
- Podiatrist
- Mesa, AZ
National Provider Identifier
1366401606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0523
- Practice address
- 6242 E Arbor Ave Ste 116
Mesa, AZ 85206-1309 - Phone
- (480) 985-1093
- Fax
- (480) 296-7665
- NPI assigned
- Mar 23, 2006
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0523 | AZ | Primary |
Addresses
Primary practice location
6242 E Arbor Ave Ste 116
Mesa, AZ 85206-1309
Mailing address
PO Box 20610
Mesa, AZ 85277-0610
Phone (480) 985-1093
Other practice location 1
5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (480) 985-1093
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 532350 | Medicaid | AZ |
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: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031110000646 | AZ | Practitioner - Podiatry | 9133032758 | Practice locations: Globe, AZ; Mesa, AZ; Marana, AZ |
| O20100930085939 | AZ | DME Supplier - Physician - Podiatry | 5496967192 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mesa, AZ |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (928) 425-3261
6242 E Arbor Ave
Suite 116
Mesa, AZ 85206-1309
Phone (480) 985-1093
6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone (480) 321-2000
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1847 |
| Removal or shaving of skin growth | 963 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0523 | AZ | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748908800000",
"number": "1366401606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20610",
"city": "MESA",
"state": "AZ",
"postal_code": "852770610",
"telephone_number": "480-985-1093",
"fax_number": "480-296-7665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6242 E ARBOR AVE STE 116",
"city": "MESA",
"state": "AZ",
"postal_code": "852061309",
"telephone_number": "480-985-1093",
"fax_number": "480-296-7665"
}
],
"practiceLocations": [
{
"address_1": "5880 S Hospital Dr",
"address_purpose": "LOCATION",
"city": "Globe",
"state": "AZ",
"postal_code": "855019447",
"country_code": "US",
"telephone_number": "480-985-1093",
"fax_number": "480-296-7665",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBISON",
"first_name": "GLEN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2025-06-03",
"certification_date": "2025-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AZ",
"license": "0523",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "532350",
"state": "AZ"
}
],
"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 Jun 3, 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.
- 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.