Individual provider Active NPI

Jose L Robledo, MD

  • Otolaryngology Physician
  • Phoenix, AZ
National Provider Identifier
1861561011
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
13386 Issued in AZ
Practice address
15835 S 46TH St
Suite 132
Phoenix, AZ 85048-0446
Phone
(480) 598-9733
Fax
(480) 598-8891
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 13386 AZ Primary

Addresses

Primary practice location

15835 S 46TH St
Suite 132
Phoenix, AZ 85048-0446

Mailing address

15835 S 46TH St
Suite 132
Phoenix, AZ 85048-0446
Phone (480) 598-9733

Other identifiers 3

IdentifierTypeStateIssuer
AZ0036500OtherAZBCBS
219908MedicaidAZ
86-0429186OtherAZTRICARE

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
13386AZMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1861561011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15835 S 46TH ST",
            "address_2": "SUITE 132",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480446",
            "telephone_number": "480-598-9733",
            "fax_number": "480-598-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15835 S 46TH ST",
            "address_2": "SUITE 132",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480446",
            "telephone_number": "480-598-9733",
            "fax_number": "480-598-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLEDO",
        "first_name": "JOSE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "13386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0036500",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219908",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "86-0429186",
            "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 Mar 29, 2016; 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.