Rosvida Anne B. San Gabriel, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036091951 Issued in IL

Practice address

104 W 6TH St
Suite 303
Streator, IL 61364-2899

Phone

(815) 673-2353

Fax

(815) 673-2486

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rsangabriel44621@direct.riversidehealthcare.net

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment NPD
• Riverside Health System

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1023166535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "address_2": "SUITE 303",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-2353",
            "fax_number": "815-673-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "address_2": "SUITE 303",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-2353",
            "fax_number": "815-673-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN GABRIEL",
        "first_name": "ROSVIDA",
        "middle_name": "ANNE B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036091951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091951",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pat Sabino, MNT
• Laurie Sabol, FNP
• Arika C Safranski, APN, CNP
• Saint James Hospital
• Tori Kay Sampson
• Lynn Schneeman, P.T.
• Adam Schuler, D.P.T.
• Rebecca Sedlock, APRN
• Amanda Kaye Simpson, MA SLP
• Upendra K Sinha, MD

• Pediatrics Physician in Streator, IL
• Providers in Streator, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.