Individual provider Active NPI

Thomas F. Mertins, M.D.

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1982660213
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
268583 Issued in AZ
Practice address
18185 N 83Rd Ave
BLDG D, Suite 107
Glendale, AZ 85308-0516
Phone
(623) 583-0306
Fax
(623) 583-1349
NPI assigned
Apr 25, 2006
Last updated
Jun 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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 268583 AZ Primary

Addresses

Primary practice location

18185 N 83Rd Ave
BLDG D, Suite 107
Glendale, AZ 85308-0516

Mailing address

18185 N 83Rd Ave
BLDG D, Suite 107
Glendale, AZ 85308-0516
Phone (623) 583-0306

Other identifiers 1

IdentifierTypeStateIssuer
268583MedicaidAZ

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
268583AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1982660213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18185 N 83RD AVE",
            "address_2": "BLDG D, SUITE 107",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080516",
            "telephone_number": "623-583-0306",
            "fax_number": "623-583-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18185 N 83RD AVE",
            "address_2": "BLDG D, SUITE 107",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080516",
            "telephone_number": "623-583-0306",
            "fax_number": "623-583-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTINS",
        "first_name": "THOMAS",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "268583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268583",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.