Individual provider Active NPI

Robert Gary Brown, M.D.

  • Emergency Medicine Physician
  • Mesa, AZ
National Provider Identifier
1679504013
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12889 Issued in AZ
Practice address
Banner Mesa Medical Center
1010 N. Country Club Drive
Mesa, AZ 85201
Phone
(480) 834-1211
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12889 AZ Primary

Addresses

Primary practice location

Banner Mesa Medical Center
1010 N. Country Club Drive
Mesa, AZ 85201

Mailing address

15802 N 10TH PL
Phoenix, AZ 85022-3141

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
I20040430001168 AZ Practitioner - Emergency MedicinePractitioner - Family Practice 9133117047 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12889AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Southwest, PC Emergency Medicine CurrentSince Mar 1, 2007 Accepting new patients
Quantum Healthcare Medical Associates of Arizona, PC Emergency Medicine CurrentSince Sep 14, 2020 Accepting new patients
Team Physicians of Arizona PC Emergency Medicine Past Accepting new patients
Quantum Healthcare Medical Associates Inc. Family Medicine Past Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679504013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15802 N 10TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BANNER MESA MEDICAL CENTER",
            "address_2": "1010 N. COUNTRY CLUB DRIVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85201",
            "telephone_number": "480-834-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBERT",
        "middle_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "12889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.