Individual provider Active NPI

Mariella Calingo De Silva

  • Assisted Living Facility
  • Gilbert, AZ
National Provider Identifier
1053945378
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11113H Issued in AZ
Practice address
841 E San Angelo Ave
Gilbert, AZ 85234-3519
Phone
(702) 357-0005
Fax
(480) 664-4550
NPI assigned
Feb 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11113H AZ Primary

Addresses

Primary practice location

841 E San Angelo Ave
Gilbert, AZ 85234-3519

Mailing address

841 E San Angelo Ave
Gilbert, AZ 85234-3519
Phone (702) 357-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL11113HAZMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1053945378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 E SAN ANGELO AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343519",
            "telephone_number": "702-357-0005",
            "fax_number": "480-664-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E SAN ANGELO AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343519",
            "telephone_number": "702-357-0005",
            "fax_number": "480-664-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SILVA",
        "first_name": "MARIELLA",
        "middle_name": "CALINGO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL11113H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.