Idris Roberson
Physician • Glendale, AZ
4494 W Peoria Ave Ste 101
Glendale, AZ 853022024
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
4494 W Peoria Ave Ste 101
Glendale, AZ 853022024
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Physician: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2023
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2023-09-15NUCC Taxonomy Code: 320900000X
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
NUCC Taxonomy Code: 320600000X
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Career & Practice History
NPI enumerated September 15, 2023.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from October 2023 to November 2026.
NPI Administrative Meta
Mailing Address
4494 W Peoria Ave Ste 101
Glendale, AZ 853022024
Phone: 6026872043