Individual provider Active NPI

Robert Royal Eastman, MD

  • Emergency Medicine Physician
  • Cottonwood, AZ
National Provider Identifier
1609877505
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2021023620 Issued in MO
Practice address
269 S Candy LN
Cottonwood, AZ 86326-4158
Phone
(928) 639-6172
Fax
(928) 639-6682
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 51402 AZ
Family Medicine Physician 207Q00000X 2021023620 MO
Family Medicine Physician 207Q00000X 39761-020 WI
Family Medicine Physician 207Q00000X MD2015-0820 NM
Surgery Physician 208600000X 39761-020 WI
Emergency Medicine Physician 207P00000X 2021023620 MO Primary

Addresses

Primary practice location

269 S Candy LN
Cottonwood, AZ 86326-4158

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
32433200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200408000192 NM Practitioner - Family Practice 7911800743 Reassigns benefits to 3 organizations
I20210729001489 MO Practitioner - Emergency Medicine 7911800743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

6400 Paseo del Norte NE
Albuquerque, NM 87113-1718
Phone (505) 596-2100

Hospital & facility affiliations

  • Socorro General Hospital Hospital, Socorro, NM, CCN 321301
  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021023620MOMDFamily Medicine Physician
MD2015-0820NMMDFamily Medicine Physician
39761-020WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fedko Emergency Physicians New Mexico LLC Emergency Medicine CurrentSince Feb 1, 2021 Accepting new patients
Presbyterian Healthcare Services Family Medicine Current Accepting new patients
Camden Emergency Group LLC Emergency Medicine CurrentSince Jun 28, 2021 Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Apr 27, 2020 Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Apr 27, 2020 Accepting new patients
Presbyterian Healthcare Services Emergency Medicine Past Accepting new patients

Locations

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

900 W Ash St
Deming, NM 88030
Phone (505) 546-2761

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627

1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140

Interoperability endpoints

  • Direct secure messaging: reastman172958@direct.phs.org

Organizations & group practices 6

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 3

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1609877505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-639-6172",
            "fax_number": "928-639-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "ROBERT",
        "middle_name": "ROYAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "51402",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021023620",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39761-020",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2015-0820",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "39761-020",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2021023620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32433200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.