Individual provider Active NPI

Robert E Mutterperl, DO

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1861438822
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3369 Issued in AZ
Practice address
6296 E Grant Rd Ste 140
Tucson, AZ 85712-5876
Phone
(520) 298-3321
Fax
(888) 978-2518
NPI assigned
Jun 20, 2006
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3369 AZ Primary

Addresses

Primary practice location

6296 E Grant Rd Ste 140
Tucson, AZ 85712-5876

Mailing address

2370 Corporate Cir Ste 300
Henderson, NV 89074-7760
Phone (702) 910-3950

Other identifiers 4

IdentifierTypeStateIssuer
410348MedicaidAZ
792417MedicaidAZ
3369OtherAZAZ STATE MEDICAL LICENSE
AZ0765360OtherAZBCBSAZ

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
I20041222000558 AZ Practitioner - Internal MedicinePractitioner - General Practice 3971561101 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3369AZMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality of Life Medical Centers, LLC CurrentSince Apr 18, 2024 Accepting new patients
Cogent Healthcare of Arizona PC Internal Medicine CurrentSince Dec 24, 2016 Accepting new patients
Bacchus PC Internal Medicine Past Accepting new patients
Haven of Saguaro Valley, LLC Past Accepting new patients
Hospitalists of Arizona, Inc Internal Medicine Past Accepting new patients

Locations

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

5350 E Erickson Dr
Tucson, AZ 85712
Phone (520) 624-8935

5390 E Erickson Dr
Tucson, AZ 85712
Phone (520) 314-1545

6390 E Broadway Blvd
Tucson, AZ 85710
Phone (520) 284-7949

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1861438822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 CORPORATE CIR STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747760",
            "telephone_number": "702-910-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6296 E GRANT RD STE 140",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857125876",
            "telephone_number": "520-298-3321",
            "fax_number": "888-978-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTERPERL",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-09-12",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "3369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410348",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "792417",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE MEDICAL LICENSE",
            "identifier": "3369",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "AZ0765360",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.