NPIMap

Individual provider Active NPI

Robert D Lundell, DO

  • Family Medicine Physician
  • Casa Grande, AZ
National Provider Identifier
1740441435
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5135 Issued in AZ
Practice address
865 N Arizola Rd
Casa Grande, AZ 85122
Phone
(520) 836-3446
Fax
(520) 836-8807
NPI assigned
Jun 24, 2008
Last updated
May 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5135 AZ Primary

Addresses

Primary practice location

865 N Arizola Rd
Casa Grande, AZ 85122

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446

Other identifiers 4

IdentifierTypeStateIssuer
521745MedicaidAZ
ZFQ31815OtherMEDICARE
03-1815OtherMEDICARE
Z138272OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000581 AZ Practitioner - Family Practice 0840322533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709
Phone (480) 512-3700

2225 W Southern Ave
Suite a
Mesa, AZ 85202-4716
Phone (623) 888-3502

Hospital & facility affiliations

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
5135AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients

Locations

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

2225 W Southern Ave
Mesa, AZ 85202
Phone (480) 412-4101

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142
Phone (480) 512-3700

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

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1740441435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446",
            "fax_number": "520-836-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 N ARIZOLA RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85122",
            "telephone_number": "520-836-3446",
            "fax_number": "520-836-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "5135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521745",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ZFQ31815",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "03-1815",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z138272",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.