Active NPI
Michelle Dwulit, M.D.
- Internal Medicine Physician
- Phoenix, AZ
National Provider Identifier
1033485206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 50095
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015135 | Medicaid | AZ |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50095 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.