Active NPI
Mark Evan Gerber, MD
- Pediatric Otolaryngology Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Otolaryngology Physician
- License
- 58195
- Practice address
- 1920 E Cambridge Ave Ste 201
Phoenix, AZ 85006-1462 - Phone
- (602) 933-3277
- Fax
- (602) 933-4326
- NPI assigned
- Aug 31, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036100171 | IL | |
| Pediatric Otolaryngology Physician | 207YP0228X | 58195 | AZ | Primary |
Addresses
Primary practice location
1920 E Cambridge Ave Ste 201
Phoenix, AZ 85006-1462
Mailing address
3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 499847 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036100171 | IL | MD | Otolaryngology Physician |
| 58195 | AZ | MD | Pediatric Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Otolaryngology | Current | Accepting new patients |
| Phoenix Children'S Medical Group | Current | Accepting new patients | |
| Phoenix Children'S Hospital | Current | Accepting new patients | |
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Phoenix Children'S Medical Group | Current | Accepting new patients |
Locations
6524 W Sack Dr
Ste 130
Glendale, AZ 85308
1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777
1920 E Cambridge Ave
Ste 201
Phoenix, AZ 85006
Phone (602) 254-5561
1920 E Cambridge Ave
Ste 200
Phoenix, AZ 85006
Phone (602) 933-0965
3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814
9532 Eagle Way
Chicago, IL 60678
49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575
1000 Central St
Ste 610
Evanston, IL 60201
Phone (847) 570-1015
2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
Organizations & group practices 5
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.
-
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
Otolaryngology
-
- Multi-Specialty Clinic/Center
- Mesa, AZ
- NPI 1487814240
-
- Multi-Specialty Clinic/Center
- Glendale, AZ
- NPI 1679703441
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566518400000",
"number": "1487765319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 E CAMELBACK RD STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182327",
"telephone_number": "602-933-1813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 E CAMBRIDGE AVE STE 201",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850061462",
"telephone_number": "602-933-3277",
"fax_number": "602-933-4326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERBER",
"first_name": "MARK",
"middle_name": "EVAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2019-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036100171",
"primary": false
},
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "AZ",
"license": "58195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "499847",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.