Active NPI
Robin Reesal, MD
- Psychiatry Physician
- Mesa, AZ
National Provider Identifier
1609021542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 40348
- Practice address
- 1255 W Baseline Rd
Mesa, AZ 85202-5820 - Phone
- (480) 820-5422
- Fax
- (480) 775-4938
- NPI assigned
- Nov 19, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 40348 | AZ | Primary |
Addresses
Primary practice location
1255 W Baseline Rd
Mesa, AZ 85202-5820
Mailing address
1255 W Baseline Rd Ste 138B
Mesa, AZ 85202-5821
Phone (480) 820-5422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40348 | Other | AZ | MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40348 | AZ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335052800000",
"number": "1609021542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 W BASELINE RD STE 138B",
"city": "MESA",
"state": "AZ",
"postal_code": "852025821",
"telephone_number": "480-820-5422",
"fax_number": "480-775-4938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 W BASELINE RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852025820",
"telephone_number": "480-820-5422",
"fax_number": "480-775-4938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESAL",
"first_name": "ROBIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-19",
"last_updated": "2012-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "40348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "40348",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.