Individual provider Active NPI

Michelle Dwulit, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1033485206
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50095 Issued in AZ
Practice address
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone
(602) 344-5146
NPI assigned
Mar 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50095 AZ Primary

Addresses

Primary practice location

2525 E Roosevelt St
Phoenix, AZ 85008-4948

Mailing address

2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone (602) 344-5146

Other identifiers 1

IdentifierTypeStateIssuer
015135MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50095AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1033485206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWULIT",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-31",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "50095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015135",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.