Active NPI
Gabor S Jilly, MD
- Cardiovascular Disease Physician
- Peoria, AZ
National Provider Identifier
1649268723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 22594
- Practice address
- 13128 N 94TH Dr
No 100
Peoria, AZ 85381-4252 - Phone
- (623) 876-8816
- Fax
- (623) 933-6739
- NPI assigned
- Oct 12, 2005
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 22594 | AZ | Primary |
Addresses
Primary practice location
13128 N 94TH Dr
No 100
Peoria, AZ 85381-4252
Mailing address
13128 N 94TH Dr
Suite100
Peoria, AZ 85381-4252
Phone (623) 876-8816
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WCFKQ | Other | AZ | SUN HEALTH PHYSICIANS |
| 173948 | Medicaid | AZ |
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 |
|---|---|---|---|
| 22541 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun Health MRI Center | Past | Accepting new patients | |
| Hospital Development of West Phoenix Inc | Cardiovascular Disease | Past | Accepting new patients |
| Banner Sun City Medical Group | Past | 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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Sun City, AZ
- NPI 1902067200
-
- Cardiovascular Disease Physician
- Goodyear, AZ
- NPI 1013100692
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Sun City West, AZ
- NPI 1427001379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345680000000",
"number": "1649268723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13128 N 94TH DR",
"address_2": "SUITE100",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814252",
"telephone_number": "623-876-8816",
"fax_number": "623-933-6739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13128 N 94TH DR",
"address_2": "NO 100",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814252",
"telephone_number": "623-876-8816",
"fax_number": "623-933-6739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JILLY",
"first_name": "GABOR",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-12",
"last_updated": "2012-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "AZ",
"license": "22594",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUN HEALTH PHYSICIANS",
"identifier": "WCFKQ",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "173948",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.