Individual provider Active NPI

Travis Fisher, MD

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1366536732
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
96244 Issued in NM
Practice address
10238 E Hampton Ave Ste 508
Mesa, AZ 85209-3321
Phone
(480) 834-7546
Fax
(480) 833-8313
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 96244 NM Primary

Addresses

Primary practice location

10238 E Hampton Ave Ste 508
Mesa, AZ 85209-3321

Mailing address

1855 N Stapley Dr
Mesa, AZ 85203-3002
Phone (480) 834-7546

Other identifiers 2

IdentifierTypeStateIssuer
201538MedicaidAZ
L6372MedicaidNM

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161014001165 AZ Practitioner - Internal MedicinePractitioner - Family Practice 1153463997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
University of Colorado School of Medicine, Denver, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RHG of Arizona PCGroup PAC ID 9436689445, 18 clinicians

Practice addresses (Care Compare)

10238 E Hampton Ave
Suite 508
Mesa, AZ 85209-3321
Phone (480) 834-7546

Hospital & facility affiliations

  • Honorhealth Four Peaks Medical Center Hospital, Mesa, AZ, CCN 030121

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
96244NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Technologies, LLC CurrentSince Oct 1, 2016 Accepting new patients
RHG of Arizona, PC CurrentSince Dec 23, 2024 Accepting new patients

Locations

5656 S Power Rd
Ste 126
Gilbert, AZ 85295

10238 E Hampton Ave
Mesa, AZ 85209
Phone (480) 357-0366

10238 E Hampton Ave
Ste 506
Mesa, AZ 85209
Phone (928) 487-5051

10238 E Hampton Ave
Ste 508
Mesa, AZ 85209
Phone (480) 358-6187

1855 N Stapley Dr
Mesa, AZ 85203
Phone (480) 545-0031

1492 S Mill Ave
Ste 101
Tempe, AZ 85281
Phone (480) 257-2740

Interoperability endpoints

  • Direct secure messaging: travis.fisher.1@32866.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1366536732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 N STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033002",
            "telephone_number": "480-834-7546",
            "fax_number": "480-833-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE STE 508",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093321",
            "telephone_number": "480-834-7546",
            "fax_number": "480-833-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "TRAVIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "96244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201538",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L6372",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.