Individual provider Active NPI

Robert Ian Marouk, DO

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Phoenix, AZ
National Provider Identifier
1689748311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
3583 Issued in AZ
Practice address
3900 E Camelback Rd
Suite 200
Phoenix, AZ 85018
Phone
(602) 354-7600
Fax
(602) 354-7066
NPI assigned
Nov 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 3583 AZ Primary

Addresses

Primary practice location

3900 E Camelback Rd
Suite 200
Phoenix, AZ 85018

Mailing address

477 Mead Place
Chandler, AZ 85249
Phone (480) 659-1782

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
I20230705000348 AZ Practitioner - Family Practice 6901265263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6051 E 34TH St Yuma
Yuma, AZ 85365-4889
Phone (928) 294-9207

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3583AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince Apr 26, 2023 Accepting new patients
Complexcare Medical Group Southwest H PLLC CurrentSince Feb 3, 2026 Accepting new patients
State of Arizona State Dept of Finance Past Accepting new patients
Bradley K Becker, PC Past Accepting new patients

Locations

4141 S Herrera Way
Phoenix, AZ 85012
Phone (602) 248-1550

6051 E 34th St
Yuma, AZ 85365
Phone (928) 247-8300

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689748311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 MEAD PLACE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85249",
            "telephone_number": "480-659-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E CAMELBACK RD",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85018",
            "telephone_number": "602-354-7600",
            "fax_number": "602-354-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROUK",
        "first_name": "ROBERT",
        "middle_name": "IAN",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "AZ",
            "license": "3583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.