Michael J Gengle, PA-C, DDS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5304 Issued in AZ

Practice address

9787 N 91St St
# 101
Scottsdale, AZ 85258-5088

Phone

(480) 845-0429

Fax

(480) 563-8009

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Az Health Centers, PLLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Phoenix, AZ
  • NPI 1992119986
  NPD

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1831310879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10488 E MERCER LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852596509",
            "telephone_number": "623-680-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9787 N 91ST ST",
            "address_2": "# 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585088",
            "telephone_number": "480-845-0429",
            "fax_number": "480-563-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENGLE",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PA-C, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D3023",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gemini Group, LLC
• Kelly Darlyne Gemmill, LMSW
• Genesis Behavioral Therapy Group
• Lynn Ann Genet, D.C.
• Genetic Technological Innovations, LLC
• Frank J Genova, MD
• Genrx Corp
• Genrx Corp
• Genrx Corp.
• Jacquelyn Gensen

• Physician Assistant in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.