Individual provider Active NPI

Amelia Gallitano-Mendel, MD PHD

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1093731218
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
41033 Issued in AZ
Practice address
650 E Indian School Rd
Phoenix, AZ 85012-1839
Phone
(602) 277-5551
Fax
(602) 827-2130
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2001012039 MO
Psychiatry Physician 2084P0800X 41033 AZ Primary

Addresses

Primary practice location

650 E Indian School Rd
Phoenix, AZ 85012-1839

Mailing address

425 N 5TH St
Phoenix, AZ 85004-2157
Phone (602) 827-2131

Other identifiers 1

IdentifierTypeStateIssuer
160456OtherMO-BLUE SHIELD

Other names 1

  • Amelia Gallitano Professional name

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)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
41033AZMDPsychiatry Physician
2001012039MOMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1093731218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N 5TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042157",
            "telephone_number": "602-827-2131",
            "fax_number": "602-827-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551",
            "fax_number": "602-827-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLITANO-MENDEL",
        "first_name": "AMELIA",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2001012039",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "41033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO-BLUE SHIELD",
            "identifier": "160456",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMELIA",
            "last_name": "GALLITANO",
            "credential": "MD PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Apr 18, 2013; 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.