Active NPI
Donald Joseph Gentile, MD
- Anesthesiology Physician
- Lebanon, IN
National Provider Identifier
1154658078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01028957A
- Practice address
- 2605 N Lebanon St
Lebanon, IN 46052-1476 - Phone
- (317) 614-9817
- Fax
- (317) 614-9655
- NPI assigned
- Nov 13, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01028957A | IN | Primary |
Addresses
Primary practice location
2605 N Lebanon St
Lebanon, IN 46052-1476
Mailing address
PO Box 6069
Dept 87
Indianapolis, IN 46206-6069
Phone (866) 282-7905
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100072060 | Medicaid | IN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1154658078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6069",
"address_2": "DEPT 87",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462066069",
"telephone_number": "866-282-7905",
"fax_number": "800-731-0751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 N LEBANON ST",
"city": "LEBANON",
"state": "IN",
"postal_code": "460521476",
"telephone_number": "317-614-9817",
"fax_number": "317-614-9655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTILE",
"first_name": "DONALD",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-13",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01028957A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100072060",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.