Individual provider Active NPI

Glen N Robison, DPM

  • Podiatrist
  • Mesa, AZ
National Provider Identifier
1366401606
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0523 Issued in AZ
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

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
532350MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1847
Removal or shaving of skin growth963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0523AZMDPodiatrist

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

Verify at the official NPI Registry.