Individual provider Active NPI

Roger L McCoy II, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1558322297
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22472 Issued in AZ
Practice address
4545 E Chandler Blvd
Suite 104
Phoenix, AZ 85048-7643
Phone
(480) 728-4400
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22472 AZ Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 22472 AZ

Addresses

Primary practice location

4545 E Chandler Blvd
Suite 104
Phoenix, AZ 85048-7643

Mailing address

File 56765
Los Angeles, CA 90074-6765
Phone (602) 406-3860

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
I20080911000283 AZ Practitioner - Emergency Medicine 5890887707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wright State University Boonshoft School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1320 N 10TH St
Suite B
Phoenix, AZ 85006-2710
Phone (602) 839-7285

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22472AZMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Aug 1, 2023 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Aug 1, 2023 Accepting new patients
Banner -- University Primary Care Physicians LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1320 N 10th St
Ste B
Phoenix, AZ 85006
Phone (602) 631-3181

755 E McDowell Rd
Ste 201
Phoenix, AZ 85006

4200 E Camelback Rd
Ste 104
Phoenix, AZ 85018
Phone (602) 229-2110

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

7400 N Dobson Rd
Ste 201
Scottsdale, AZ 85256
Phone (480) 733-7400

Organizations & group practices 3

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 1

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1558322297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 56765",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900746765",
            "telephone_number": "602-406-3860",
            "fax_number": "602-406-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E CHANDLER BLVD",
            "address_2": "SUITE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487643",
            "telephone_number": "480-728-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "ROGER",
        "middle_name": "L",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "22472",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "22472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.