Individual provider Active NPI

Robert T. Fukuchi, MD

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1831107481
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6532 Issued in AZ
Practice address
350 W Thomas Rd
St. Joseph'S Hospital
Phoenix, AZ 85013-4409
Phone
(602) 406-3000
Fax
(602) 406-7165
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 6532 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
St. Joseph'S Hospital
Phoenix, AZ 85013-4409

Mailing address

1241 W Mineral Ave
Suite 100
Littleton, CO 80120-5685
Phone (303) 759-0854

Other identifiers 1

IdentifierTypeStateIssuer
294877MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6532AZMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Emergency Physicians, PC Past Accepting new patients

Organizations & group practices 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1831107481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 W MINERAL AVE",
            "address_2": "SUITE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205685",
            "telephone_number": "303-759-0854",
            "fax_number": "303-759-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "address_2": "ST. JOSEPH'S HOSPITAL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-3000",
            "fax_number": "602-406-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUCHI",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "6532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294877",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.