Individual provider Active NPI

Mary Cecilia Gentile, DO

  • Family Medicine Physician
  • Temecula, CA
National Provider Identifier
1861480998
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39870 Issued in CO
Practice address
27699 Jefferson Ave
# 312
Temecula, CA 92590-2661
Phone
(951) 676-4221
Fax
(951) 676-0032
NPI assigned
Oct 12, 2005
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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 39870 CO Primary

Addresses

Primary practice location

27699 Jefferson Ave
# 312
Temecula, CA 92590-2661

Mailing address

27699 Jefferson Ave
#312
Temecula, CA 92590
Phone (951) 676-4221

Other identifiers 2

IdentifierTypeStateIssuer
89121228MedicaidCO
080178582OtherTRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120626000399 CA Practitioner - Family PracticePractitioner - Internal Medicine 1850556812 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Associates of California PCGroup PAC ID 2668812215, 55 clinicians

Practice addresses (Care Compare)

36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone (951) 677-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6416CAMDAcupuncturist
39870COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Physicians Network Inc CurrentSince Jun 5, 2019 Accepting new patients
Galen Inpatient Physicians Inc CurrentSince Apr 8, 2012 Accepting new patients
Acute Care Associates of California PC Family Medicine CurrentSince Feb 18, 2024 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Apr 8, 2012 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients

Locations

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

41593 Winchester Rd
Ste 101
Temecula, CA 92590
Phone (951) 719-1111

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Organizations & group practices 5

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.

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1861480998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE",
            "address_2": "#312",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "92590",
            "telephone_number": "951-676-4221",
            "fax_number": "951-676-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE",
            "address_2": "# 312",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902661",
            "telephone_number": "951-676-4221",
            "fax_number": "951-676-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "MARY",
        "middle_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "39870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89121228",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "080178582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.