NPIMap

Individual provider Active NPI

Michael Benjamin Gentry, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Dayton, OH
National Provider Identifier
1043509250
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2019-00080 Issued in NC
Practice address
3535 Southern Blvd
Dayton, OH 45429
Phone
(937) 395-8849
NPI assigned
Mar 29, 2011
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2019-00080 NC Primary

Addresses

Primary practice location

3535 Southern Blvd
Dayton, OH 45429

Mailing address

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4814

Other practice location 1

3535 Southern Blvd
Dayton, OH 45429
Phone (937) 395-8849

Other practice location 2

200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone (704) 384-4814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826003297 NC Practitioner - Pathology 6002184066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of North Carolina at Chapel Hill School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Pathology Group PLLCGroup PAC ID 7810955168, 23 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4000

10905 Providence Rd W
Charlotte, NC 28277-1538
Phone (704) 384-4814

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4815

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 210-5488

8201 Health Loop
Charlotte, NC 28215-7072
Phone (980) 302-1410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.51 of 100Reported as group
Quality
73.46
Improvement activities
40
Cost
73.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-00080NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Pathology Group PLLC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2019 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

5700 Southwyck Blvd
Toledo, OH 43614

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1043509250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4814",
            "fax_number": "704-384-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-395-8849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45429",
            "country_code": "US",
            "telephone_number": "937-395-8849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-4814",
            "fax_number": "704-384-5770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "MICHAEL",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2019-00080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.