OrganizationActive
Mesa Physician Group
NPI 1104447788 · General Practice Physician · Mesa, AZ
Provider details
- NPI number
- 1104447788
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeremiah Faber, Ceo(480) 258-3635
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5151 E Broadway Rd Ste 105
Mesa, AZ 85206-1346
Phone: (480) 809-6587
Street-level locationGet directions
Mailing address
Po Box 964
Gilbert, AZ 85299-0964
Registry dates
- Enumerated
- 2020-05-05
- Last updated
- 2020-05-06
- Certified
- 2020-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.