Individual provider Active NPI

Wesley A Robertson, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1780263285
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
73771 Issued in AZ
Practice address
1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849
Phone
(602) 839-3927
Fax
(602) 839-4233
NPI assigned
Apr 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 73771 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849

Mailing address

4504 N Via Entrada Apt 112
Tucson, AZ 85718-5863
Phone (719) 331-9766

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
I20240814004519 AZ Practitioner - Internal MedicinePractitioner - Hospitalist 6204231061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince Sep 16, 2024 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Sep 16, 2024 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

Organizations & group practices 3

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1780263285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 N VIA ENTRADA APT 112",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857185863",
            "telephone_number": "719-331-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 508",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062849",
            "telephone_number": "602-839-3927",
            "fax_number": "602-839-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "WESLEY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "73771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.