Individual provider Active NPI

Allen Max Germaine Jr., MD

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1689658908
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15647 Issued in AZ
Practice address
2345 E Southern Ave
#101
Mesa, AZ 85204-5417
Phone
(480) 893-2345
Fax
(480) 926-0495
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15647 AZ Primary

Addresses

Primary practice location

2345 E Southern Ave
#101
Mesa, AZ 85204-5417

Mailing address

2345 E Southern Ave
#101
Mesa, AZ 85204-5417
Phone (480) 893-2345

Other identifiers 2

IdentifierTypeStateIssuer
274796MedicaidAZ
Z108141OtherAZPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060221000777 AZ Practitioner - Family PracticePractitioner - General Surgery 4082629522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family First Physicians PLLCGroup PAC ID 3678588100, 3 clinicians

Practice addresses (Care Compare)

2345 E Southern Ave
Suite 101
Mesa, AZ 85204-5419
Phone (480) 893-2345

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15647AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Primary Care Physicians, LLC Family Medicine CurrentSince Sep 1, 2016 Accepting new patients

Locations

5620 W Thunderbird Rd
Ste F1
Glendale, AZ 85306
Phone (602) 938-6960

2345 E Southern Ave
Ste 101
Mesa, AZ 85204
Phone (480) 893-2345

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1689658908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E SOUTHERN AVE",
            "address_2": "#101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045417",
            "telephone_number": "480-893-2345",
            "fax_number": "480-926-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 E SOUTHERN AVE",
            "address_2": "#101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045417",
            "telephone_number": "480-893-2345",
            "fax_number": "480-926-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMAINE",
        "first_name": "ALLEN",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "15647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274796",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z108141",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.