Active NPI
Roger L McCoy II, M.D.
- Family Medicine Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 22472
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22472 | AZ | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner - University Physician Specialists LLC | Current | Accepting new patients | |
| Banner - University Physician Specialists LLC | Current | Accepting new patients | |
| Banner -- University Primary Care Physicians LLC | Current | 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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1437529245
-
- Primary Care Clinic/Center
- Payson, AZ
- NPI 1154791960
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1164255865
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1841224870
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.