Active NPI
Robert Simmonds Mindell, MD
- Plastic and Reconstructive Surgery Physician
- Phoenix, AZ
National Provider Identifier
1396905444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 6168743-1205
- Practice address
- 2762 E. Yale St.
Phoenix, AZ 85008 - Phone
- (480) 707-2292
- NPI assigned
- Jun 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 6168743-1205 | UT | Primary |
| Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 2082S0099X | 18971 | AZ |
Addresses
Primary practice location
2762 E. Yale St.
Phoenix, AZ 85008
Mailing address
2762 E. Yale St.
Phoenix, AZ 85008
Phone (480) 707-2292
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18971 | AZ | MD | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician |
| 6168743-1205 | UT | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1396905444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2762 E. YALE ST.",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85008",
"telephone_number": "480-707-2292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2762 E. YALE ST.",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85008",
"telephone_number": "480-707-2292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINDELL",
"first_name": "ROBERT",
"middle_name": "SIMMONDS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-12",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "UT",
"license": "6168743-1205",
"primary": true
},
{
"code": "2082S0099X",
"taxonomy_group": "",
"desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
"state": "AZ",
"license": "18971",
"primary": false
}
],
"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 Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.