Active NPI
Gail Stotsky, MD
- Pediatrics Physician
- Ganado, AZ
National Provider Identifier
1215976907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01042055A
- Practice address
- US 191 & Az 264
Ganado, AZ 86505 - Phone
- (928) 755-4632
- Fax
- (928) 755-4831
- NPI assigned
- Jun 6, 2006
- Last updated
- May 28, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD2023-0110 | NM | |
| Pediatrics Physician | 208000000X | 01042055A | IN | Primary |
Addresses
Primary practice location
US 191 & Az 264
Ganado, AZ 86505
Mailing address
PO Box 649
Fort Defiance, AZ 86504-0649
Other practice location 1
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Phone (928) 729-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100421030 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2023-0110 | NM | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748390400000",
"number": "1215976907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 649",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "865040649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US 191 & AZ 264",
"city": "GANADO",
"state": "AZ",
"postal_code": "86505",
"telephone_number": "928-755-4632",
"fax_number": "928-755-4831"
}
],
"practiceLocations": [
{
"address_1": "Corner of Route N12 and N7",
"address_purpose": "LOCATION",
"city": "Fort Defiance",
"state": "AZ",
"postal_code": "86504",
"country_code": "US",
"telephone_number": "928-729-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOTSKY",
"first_name": "GAIL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2025-05-28",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "MD2023-0110",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01042055A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100421030",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ganado, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.