NPIMap

Individual provider Active NPI

Philip A Gentile, PA

  • Physician Assistant
  • Odessa, TX
National Provider Identifier
1528095361
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03335 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-1190
Fax
(432) 640-3489
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03335 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

1717 Main St
Suite 5300
Dallas, TX 75201-4605
Phone (214) 712-2074

Other practice location 1

2101 Lakeview Pkwy Ste 300
Rowlett, TX 75088-3313
Phone (972) 412-1712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040312000608 TX Practitioner - Physician Assistant 9739078213 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

104 S Main St
Keller, TX 76248-5003
Phone (214) 295-9385

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

377 W Campbell Rd
Suite 100
Richardson, TX 75080-3695
Phone (469) 232-2945

3821 W Spring Creek Pkwy
Plano, TX 75023-3808
Phone (972) 599-0077

454 N Jim Wright Fwy
White Settlement, TX 76108-1437
Phone (682) 703-4505

4844 Greenville Ave
Dallas, TX 75206-4120
Phone (214) 295-9410

9540 Garland Rd
Dallas, TX 75218-5004
Phone (214) 321-0015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
Harold Wagner DO PA Past Accepting new patients
Texas Em-1 Medical Services PA Physician Assistant Past Accepting new patients
Texas Emergency Rooms Services, PA Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Athens Emergency Medicine Associates PA Past Accepting new patients
Motley Emergency Physicians Past Accepting new patients
Camino Real Emergency Physicians PLLC Physician Assistant Past Accepting new patients
Indelible Health & Wellness LLC Past Accepting new patients
Dallas Emergency Physicians PLLC Past Accepting new patients
Medexpress Urgent Care Texas, P.a. Past Accepting new patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pgentile360232@ahs.direct-ci.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1528095361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "SUITE 5300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014605",
            "telephone_number": "214-712-2074",
            "fax_number": "214-712-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1190",
            "fax_number": "432-640-3489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Lakeview Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Rowlett",
            "state": "TX",
            "postal_code": "750883313",
            "country_code": "US",
            "telephone_number": "972-412-1712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "PHILIP",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.