Individual provider Active NPI

Robert C Grayson, MD

  • Obstetrics & Gynecology Physician
  • Phoenix, AZ
National Provider Identifier
1649234279
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21634 Issued in AZ
Practice address
16611 S 40TH St
Suite 180
Phoenix, AZ 85048
Phone
(480) 785-2100
Fax
(480) 785-2100
NPI assigned
Apr 12, 2006
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21634 AZ Primary

Addresses

Primary practice location

16611 S 40TH St
Suite 180
Phoenix, AZ 85048

Mailing address

2545 W Frye Rd
Suite 9
Chandler, AZ 85224-6273
Phone (480) 505-4258

Other identifiers 1

IdentifierTypeStateIssuer
174996MedicaidAZ

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
I20040817000352 AZ Practitioner - Obstetrics/Gynecology 4082687132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Southern California Keck School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Contemporary Women's Care PCGroup PAC ID 0648256156, 23 clinicians

Practice addresses (Care Compare)

16611 S 40TH St
Suite 180
Phoenix, AZ 85048-0566
Phone (480) 785-2100

2550 E Guadalupe Rd
Suite 109
Gilbert, AZ 85234-5114
Phone (480) 505-4475

6301 S McClintock Dr
Suite 215
Tempe, AZ 85283-3394
Phone (480) 820-6657

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21634AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Obstetrics & Gynecology PastSince Jul 30, 1993 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1649234279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 W FRYE RD",
            "address_2": "SUITE 9",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246273",
            "telephone_number": "480-505-4258",
            "fax_number": "480-275-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST",
            "address_2": "SUITE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85048",
            "telephone_number": "480-785-2100",
            "fax_number": "480-785-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "21634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174996",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.