DR. JAVIER IGNACIO GENTILE M.D., NPI 1780125906 — PHOENIX (AZ)

NPI 1780125906

3+ Years Experience Individual

DR. JAVIER IGNACIO GENTILE M.D.

03/20/2017
PROVIDER ENUMERATION DATE
12/18/2018
LAST UPDATE DATE
1780125906
NPI NUMBER

About DR. JAVIER IGNACIO GENTILE

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DR. JAVIER IGNACIO GENTILE is a provider established in PHOENIX, AZ. The NPI number of DR. JAVIER IGNACIO GENTILE is 1780125906 and was assigned on 03/20/2017. The practitioners primary taxonomy code is: 204F00000X with license number: LT000771 PA .

Mailing address

  • City: PHOENIX
  • State: AZ
  • Postal code: 850182327
  • Phone: 6029331813
  • Address: 3200 E CAMELBACK RD STE 250

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1780125906
  • Phone : 6029332693
  • Fax : 6029332697
  • Postalcode : 850167710
  • Address : 1919 E THOMAS RD

Provider taxonomy - Transplant Surgery

  • Taxonomy code: 204F00000X
  • License number: LT000771
  • License state: PA

The taxonomy is not the primary taxonomy.

Healthcare provider taxonomy #2 - Thoracic Surgery (Cardiothoracic Vascular Surgery)

  • Taxonomy code: 208G00000X
  • License number: MT213590
  • License state: PA

The taxonomy is not the primary taxonomy.

Taxonomy description: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Contacts:

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  • DR. JAVIER IGNACIO GENTILE M.D.
  • Address : 1919 E THOMAS RD
  • Region : PHOENIX, AZ
  • NPI : 1780125906
  • Phone : 6029332693
  • Fax : 6029332697
  • Postalcode : 850167710

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1919 E THOMAS RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850167710
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6029332693
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6029332697
The fax number associated with the location address of the provider being identified.
NPI1780125906
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1204F00000X
Provider Enumeration Date03/20/2017
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated12/18/2018
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. JAVIER IGNACIO GENTILE
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address3200 E CAMELBACK RD STE 250
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NamePHOENIX
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code850182327
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6029331813
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1204F00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Transplant Surgery
Provider License Number 1LT000771
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1PA
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2208G00000X
Healthcare Provider Taxonomy 2Thoracic Surgery (Cardiothoracic Vascular Surgery)
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Provider License Number 2MT213590
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2PA
Healthcare Provider Primary Taxonomy Switch 2N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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