Individual provider Active NPI

Robert James McLeod, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1992193957
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5929 Issued in AZ
Practice address
6750 E Baywood Ave
Suite 503
Mesa, AZ 85206-1749
Phone
(480) 543-3030
Fax
(480) 543-3031
NPI assigned
Dec 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X 74 OK
Physician Assistant 363A00000X 5929 AZ Primary

Addresses

Primary practice location

6750 E Baywood Ave
Suite 503
Mesa, AZ 85206-1749

Mailing address

6750 E Baywood Ave Ste 503
Mesa, AZ 85206-1749
Phone (480) 543-3030

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150427002465 AZ Practitioner - Physician Assistant 0840519773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1900 N Higley Rd
Banner Health Clinic
Gilbert, AZ 85234-1604
Phone (480) 543-2688

6644 E Baywood Ave
Banner Health Clinic
Mesa, AZ 85206-1747
Phone (480) 321-2000

6750 E Baywood Ave
Mesa, AZ 85206-1749

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

  • Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105
  • Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
74OKMDPerfusionist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Feb 23, 2015 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Feb 23, 2015 Accepting new patients

Locations

1828 E Florence Blvd
Ste 112
Casa Grande, AZ 85122
Phone (520) 374-8915

1828 E Florence Blvd
Ste 110
Casa Grande, AZ 85122
Phone (520) 381-6736

6750 E Baywood Ave
Ste 503
Mesa, AZ 85206
Phone (480) 543-3030

122 E Main St
Payson, AZ 85541
Phone (928) 474-2888

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

37100 N Gantzel Rd
Ste 107
San Tan Vly, AZ 85140
Phone (480) 394-4480

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1992193957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 E BAYWOOD AVE STE 503",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061749",
            "telephone_number": "480-543-3030",
            "fax_number": "480-543-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 E BAYWOOD AVE",
            "address_2": "SUITE 503",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061749",
            "telephone_number": "480-543-3030",
            "fax_number": "480-543-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-29",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "OK",
            "license": "74",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.