Individual provider Active NPI

Gina D Montion, MD

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1366435612
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30443 Issued in AZ
Practice address
15650 N Black Canyon Hwy
Suite 100
Phoenix, AZ 85053-4064
Phone
(602) 866-0550
Fax
(602) 993-5788
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30443 AZ Primary

Addresses

Primary practice location

15650 N Black Canyon Hwy
Suite 100
Phoenix, AZ 85053-4064

Mailing address

15650 N Black Canyon Hwy
Suite 100
Phoenix, AZ 85053-4064
Phone (602) 866-0550

Other identifiers 1

IdentifierTypeStateIssuer
706054MedicaidAZ

Other names 1

  • Gina Diane Montion Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30443AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Pediatric Group Specialists, LTD. Pediatrics PastSince Dec 13, 2022 Accepting new patients

Locations

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

4375 E Irma Ln
Phoenix, AZ 85050
Phone (480) 890-5800

4720 E Greenway Rd
Phoenix, AZ 85032
Phone (602) 439-6000

Organizations & group practices 2

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1366435612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 N BLACK CANYON HWY",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534064",
            "telephone_number": "602-866-0550",
            "fax_number": "602-993-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 N BLACK CANYON HWY",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534064",
            "telephone_number": "602-866-0550",
            "fax_number": "602-993-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTION",
        "first_name": "GINA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "30443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706054",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "MONTION",
            "middle_name": "DIANE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.