NPIMap

Organization Active NPI

Mentis Reo, LLC.

  • Developmental Disabilities Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1609541283
Registry record updated Aug 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
MENTIS REO, LLC.
Practice address
690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055
Phone
(480) 820-6366
NPI assigned
Aug 16, 2021
Last updated
Aug 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2024

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
VP & Sr Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055

Mailing address

690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055

Other practice location 1

1783 E Queen Creek Rd Ste 1
Chandler, AZ 85286-2013
Phone (480) 820-6366

Other practice location 2

1515 E Florence Blvd
Casa Grande, AZ 85122-5334
Phone (800) 388-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220311001168 AZ Part B Supplier - Clinic/Group Practice 9739579715 Receives reassigned benefits from 25 practitioners
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory
Tax ID family
Mentis Reo2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1515 E Florence Blvd
Casa Grande, AZ 85122

1515 E Florence Blvd
Ste 103
Casa Grande, AZ 85122
Phone (520) 423-8282

1783 E Queen Creek Rd
Ste 1
Chandler, AZ 85286
Phone (480) 820-6366

690 E Warner Rd
Ste 105
Gilbert, AZ 85296
Phone (480) 820-0462

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724544000000",
    "number": "1609541283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963055",
            "telephone_number": "480-820-6366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1783 E Queen Creek Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852862013",
            "country_code": "US",
            "telephone_number": "480-820-6366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 E Florence Blvd",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851225334",
            "country_code": "US",
            "telephone_number": "800-388-5150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MENTIS REO, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP & SR ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.