Individual provider Active NPI

Monique Gurgel Lin, MD

  • Maternal & Fetal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1720018195
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
31079 Issued in AZ
Practice address
635 E Baseline Rd
Phoenix, AZ 85042-6551
Phone
(602) 243-7277
Fax
(602) 243-1235
NPI assigned
Jul 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X DR0055754 CO
Maternal & Fetal Medicine Physician 207VM0101X 31079 AZ Primary

Addresses

Primary practice location

635 E Baseline Rd
Phoenix, AZ 85042-6551

Mailing address

635 E Baseline Rd
Phoenix, AZ 85042-6551
Phone (602) 243-7277

Other identifiers 1

IdentifierTypeStateIssuer
186017MedicaidAZ

Other names 1

  • Monique Gurgel Johnson Former name

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
I20070416000508 AZ Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 9335117548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albany Medical College of Union University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Park Health CenterGroup PAC ID 8325949647, shared by 11 NPIs, 117 clinicians

Practice addresses (Care Compare)

6601 W Thomas Rd
Phoenix, AZ 85033-5700
Phone (602) 243-7277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31079AZMDMaternal & Fetal Medicine Physician
DR0055754COMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jan 1, 2023 Accepting new patients
District Medical Group, Inc CurrentSince Jan 1, 2023 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Mountain Park Health Center CurrentSince Aug 14, 2017 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Aug 14, 2017 Accepting new patients
Obstetrix Medical Group of Phoenix PC Past Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

2702 N 3rd St
Ste 4020
Phoenix, AZ 85004
Phone (602) 323-3345

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

303 E Baseline Rd
Phoenix, AZ 85042
Phone (602) 277-6181

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

635 E Baseline Rd
Phoenix, AZ 85042

6601 W Thomas Rd
Phoenix, AZ 85033

Interoperability endpoints

  • Direct secure messaging: monique.lin@mphc.eclinicaldirectplus.com

Organizations & group practices 8

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720018195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277",
            "fax_number": "602-243-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "MONIQUE",
        "middle_name": "GURGEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CO",
            "license": "DR0055754",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "AZ",
            "license": "31079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186017",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONIQUE",
            "last_name": "JOHNSON",
            "middle_name": "GURGEL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.