Individual provider Active NPI

Gary J. Dilla, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1114920675
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
28282 Issued in AZ
Practice address
7600 N 15TH St Ste 102
Phoenix, AZ 85020-4330
Phone
(602) 246-7410
Fax
(602) 246-7950
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 28282 AZ Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 28282 AZ

Addresses

Primary practice location

7600 N 15TH St Ste 102
Phoenix, AZ 85020-4330

Mailing address

7600 N 15TH St Ste 102
Phoenix, AZ 85020-4330
Phone (602) 246-7410

Other practice location 1

1331 N 7th St
Ste 360
Phoenix, AZ 85006-2772
Phone (602) 246-9002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110106000721 AZ Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 2365638509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Hahnemann University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Physical Medicine and Rehabilitation P CGroup PAC ID 8527044072, 2 clinicians

Practice addresses (Care Compare)

7600 N 15TH St
Suite 102
Phoenix, AZ 85020-4330
Phone (602) 246-7410

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Medicine & Rehabilitation P C Physical Medicine & Rehabilitation CurrentSince Jun 26, 2000 Accepting new patients

Locations

7600 N 15th St
Ste 102
Phoenix, AZ 85020
Phone (602) 246-7410

1331 N 7th St
Ste 360
Phoenix, AZ 85006
Phone (602) 246-9002

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEJIAD/Endpoint/IEJIAD

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1114920675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204330",
            "telephone_number": "602-246-7410",
            "fax_number": "602-246-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204330",
            "telephone_number": "602-246-7410",
            "fax_number": "602-246-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 N 7th St",
            "address_2": "Ste 360",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062772",
            "country_code": "US",
            "telephone_number": "602-246-9002",
            "fax_number": "602-246-7950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLA",
        "first_name": "GARY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "28282",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "28282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.