NPIMap

Individual provider Active NPI

Dexter M Gensolin, M. D.

  • Family Medicine Physician
  • Napoleon, OH
National Provider Identifier
1942319652
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-079093 Issued in OH
Practice address
1600 E Riverview Ave
Suite 107
Napoleon, OH 43545-9805
Phone
(419) 592-0800
Fax
(419) 592-0815
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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 35-079093 OH Primary

Addresses

Primary practice location

1600 E Riverview Ave
Suite 107
Napoleon, OH 43545-9805

Mailing address

PO Box 550
Wauseon, OH 43567-0550
Phone (419) 592-0800

Other identifiers 4

IdentifierTypeStateIssuer
080177294OtherTRAVELER MEDICARE
0151264OtherWALABOR & INDUSTRIES PROV #
8291643MedicaidWA
1090GEOtherWAREGENCE PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181128000087 TX Practitioner - Family Practice 6305814294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Butte Indian Health Service HospitalGroup PAC ID 7517852759, 42 clinicians

Practice addresses (Care Compare)

24276 166TH Airport Rd
Eagle Butte, SD 57625-1022
Phone 60596477240515

PO Box
Suite 1012
Eagle Butte, SD 57625-1012

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-079093OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Butte Indian Health Service Hospital CurrentSince Oct 15, 2018 Accepting new patients

Organizations & group practices 1

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1942319652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435670550",
            "telephone_number": "419-592-0800",
            "fax_number": "419-592-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E RIVERVIEW AVE",
            "address_2": "SUITE 107",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459805",
            "telephone_number": "419-592-0800",
            "fax_number": "419-592-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENSOLIN",
        "first_name": "DEXTER",
        "middle_name": "M",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-079093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELER MEDICARE",
            "identifier": "080177294",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES PROV #",
            "identifier": "0151264",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8291643",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER #",
            "identifier": "1090GE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Napoleon, OH

Sources for this page

Verify at the official NPI Registry.