MICAH GENTILE (NPI# 1568863843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568863843 |
| Entity Type | Individual |
| Full Name | MICAH GENTILE |
| Practice Address |
15 Mohegan Ave New London CT 06320-8100 |
| Mailing Address |
Po Box 195002 N46 Cape Sarichef Kodiak AK 99619-5002 |
| Practice Telephone | 8607046999 |
| Practice Fax Number | 8604448413 |
| Mailing Telephone | 9074875757 |
| Mailing Fax Number | 9074875151 |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2019-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 60527256 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15 MOHEGAN AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-8100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114913316 | Christopher Bellizzi | Massage Therapist | 15 Mohegan Ave, New London, CT 06320-8100 | 2005-09-22 |
| 1689204919 | Colleen Mccue | Physician Assistant | 15 Mohegan Ave, New London, CT 06320-8100 | 2020-01-26 |
| 1184146029 | Elizabeth A Fitch | Registered Nurse | 15 Mohegan Ave, Michel Hall, New London, CT 06320 | 2017-07-12 |
| 1295181709 | Katrina Rochester | Registered Nurse | 15 Mohegan Ave, New London, CT 06320-8100 | 2016-05-13 |
| 1174960223 | Karen Louise Robertson | Dental Hygienist | 15 Mohegan Ave, New London, CT 06320-8100 | 2013-05-30 |
| 1124274816 | Eugene Francis Pereira | Spec/Tech, Pathology | 15 Mohegan Ave, Uscga Medical, New London, CT 06320-4195 | 2008-08-13 |
| 1912161969 | Mark S Jadofsky | Technician, Other | 15 Mohegan Ave, U.S. Caost Guard Academy, New London, CT 06320-0052 | 2008-07-17 |
| 1275700403 | Mary Lathrop | Specialist/Technologist | 15 Mohegan Ave, Michel Hall, New London, CT 06320-8100 | 2008-05-16 |
| 1366619512 | Reina Carolina Garcia | Dental Assistant | 15 Mohegan Ave, Uscgacademy (m), New London, CT 06320-8100 | 2008-05-15 |
| 1881861599 | Sherry Kay Glidewell | Dental Hygienist | 15 Mohegan Ave, Michel Hall, New London, CT 06320-8100 | 2008-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679712053 | Elizabeth Mann | Physician Assistant | 365 Montauk Ave Ste 2.013, Lmh Urology, New London, CT 06320-4700 | 2009-02-09 |
| 1407936875 | Sarah F Whalen | Physician Assistant | 45 Franklin Street, New London, CT 06320 | 2006-10-17 |
| 1255371217 | Jason Lee Tharpe | Physician Assistant | 194 Howard St, New London, CT 06320-5544 | 2006-06-07 |
| 1700859006 | Richard Dominick Moro | Physician Assistant | 435 Montauk Ave, New London, CT 06320-4621 | 2006-02-08 |
| 1689204919 | Colleen Mccue | Physician Assistant | 15 Mohegan Ave, New London, CT 06320-8100 | 2020-01-26 |
| 1699232132 | Alyssa Wentworth | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2019-02-20 |
| 1285190462 | Keren Mariam Paul | Physician Assistant | 365 Montauk Ave, New London, CT 06320-4700 | 2019-02-13 |
| 1124590930 | Abbey Rumbold | Physician Assistant | 365 Montauk Ave, New London, CT 06320-4769 | 2018-12-19 |
| 1902324205 | Marissa Tennant | Physician Assistant | 365 Montauk Ave, New London, CT 06320-4700 | 2017-09-07 |
| 1841717535 | Laura Hoover | Physician Assistant | 365 Montauk Ave, New London, CT 06320-4700 | 2017-08-24 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.