Active NPI
Monique Gurgel Lin, MD
- Maternal & Fetal Medicine Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- 31079
- 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, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186017 | Medicaid | AZ |
Other names 1
- Monique Gurgel Johnson
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
Enrollment records 1
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 Center
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31079 | AZ | MD | Maternal & Fetal Medicine Physician |
| DR0055754 | CO | MD | Maternal & Fetal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients | |
| Mountain Park Health Center | Current | Accepting new patients | |
| Mountain Park Health Center | Current | Accepting new patients | |
| Mountain Park Health Center | Current | 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
- 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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1336472448
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1558308825
-
- Anesthesiology Physician
- Phoenix, AZ
- NPI 1093948275
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1144624339
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1386452415
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1669878567
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1710146188
-
dba Arizona Pediatric Cardiology Consultants
- Pediatric Cardiology Physician
- Phoenix, AZ
- NPI 1346269594
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.