Active NPI
Robert Ganelin, MD
- Pediatric Endocrinology Physician
- Phoenix, AZ
National Provider Identifier
1619902251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Endocrinology Physician
- License
- 3661
- Practice address
- 2601 E Roosevelt St
Phoenix, AZ 85008-4973 - Phone
- (602) 344-5200
- NPI assigned
- Jul 12, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Endocrinology Physician | 2080P0205X | 3661 | AZ | Primary |
Addresses
Primary practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
3255 E Elwood St
#110
Phoenix, AZ 85034-7256
Phone (602) 470-5043
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 |
|---|---|---|---|
| 3661 | AZ | MD | Pediatric Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Family Medicine | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619902251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3255 E ELWOOD ST",
"address_2": "#110",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850347256",
"telephone_number": "602-470-5043",
"fax_number": "602-470-5064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 E ROOSEVELT ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850084973",
"telephone_number": "602-344-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANELIN",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "AZ",
"license": "3661",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.