Individual provider Active NPI

Jerry E Ngalle

  • Home Health Aide
  • Mesa, AZ
National Provider Identifier
1487381471
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
721 E Forge Ave
Mesa, AZ 85204-4916
Phone
(602) 775-0609
Fax
(480) 687-5301
NPI assigned
Aug 1, 2022
Reactivated
Oct 4, 2022
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X AZ Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

721 E Forge Ave
Mesa, AZ 85204-4916

Mailing address

721 E Forge Ave
Mesa, AZ 85204-4916
Phone (602) 775-0609

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Care Horizon Current Accepting new patients
Ngalle Homes Care CurrentSince Oct 9, 2022 Accepting new patients
Angels Beginning ,LLC CurrentSince Aug 27, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1487381471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 E FORGE AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852044916",
            "telephone_number": "602-775-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E FORGE AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852044916",
            "telephone_number": "602-775-0609",
            "fax_number": "480-687-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGALLE",
        "first_name": "JERRY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "deactivation_date": "2022-09-27",
        "reactivation_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.