Individual provider Active NPI

Evelynn Petra Robles, FNP-C

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1467296319
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
226727 Issued in AZ
Practice address
22601 N 19TH Ave Ste 230
Phoenix, AZ 85027-1362
Phone
(602) 567-9953
NPI assigned
Jun 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 226727 AZ Primary

Addresses

Primary practice location

22601 N 19TH Ave Ste 230
Phoenix, AZ 85027-1362

Mailing address

22601 N 19TH Ave Ste 230
Phoenix, AZ 85027-1362
Phone (602) 567-9953

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813002535 AZ Practitioner - Nurse Practitioner 6901344621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RPM Care Coordination PCGroup PAC ID 6002205606, 42 clinicians

Practice addresses (Care Compare)

5333 N Pima Rd
Suite 305
Scottsdale, AZ 85250-2620
Phone (800) 985-5596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
226727AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Arizona, LLC CurrentSince Jul 17, 2024 Accepting new patients
Stillwater Hospice LLC CurrentSince May 4, 2025 Accepting new patients
Privia Medical Group Arizona, LLC CurrentSince Jul 17, 2024 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

10815 W McDowell Rd
Ste 304
Avondale, AZ 85392
Phone (623) 433-0155

7330 N 99th Ave
Ste 325
Glendale, AZ 85307
Phone (480) 398-7620

14415 W McDowell Rd
Ste D102
Goodyear, AZ 85395
Phone (623) 512-4190

111 W Cedar Ln
Ste A
Payson, AZ 85541
Phone (928) 472-4675

22601 N 19th Ave
Ste 230
Phoenix, AZ 85027
Phone (602) 567-9953

3815 E Bell Rd
Ste 4500
Phoenix, AZ 85032
Phone (602) 633-3838

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1467296319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22601 N 19TH AVE STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271362",
            "telephone_number": "602-567-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22601 N 19TH AVE STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271362",
            "telephone_number": "602-567-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLES",
        "first_name": "EVELYNN",
        "middle_name": "PETRA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "226727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.