Individual provider Active NPI

Gabrielle Morgan Benedetto

  • Physician Assistant
  • Macon, GA
National Provider Identifier
1023731148
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2922 Issued in ME
Practice address
623 Juniper LN Apt 623
Macon, GA 31220-7648
Phone
(207) 877-4357
NPI assigned
Sep 23, 2022
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2922 ME Primary

Addresses

Primary practice location

623 Juniper LN Apt 623
Macon, GA 31220-7648

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 474-5121

Other practice location 1

46 Fairview Ave
Skowhegan, ME 04976-1481
Phone (207) 474-5121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240411000642 GA Practitioner - Physician Assistant 9931547817 Reassigns benefits to 2 organizations
I20251031003059 ME Practitioner - Physician Assistant 9931547817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

46 Fairview Ave
Skowhegan, ME 04976-1481

PO Box
Suite 468
Skowhegan, ME 04976

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12215GAMDGeneral Practice Dentistry
PA2922MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince Nov 3, 2025 Accepting new patients
Houston County Emergency Group, LLC CurrentSince Mar 7, 2024 Accepting new patients
Redington-Fairview General Hospital CurrentSince Nov 3, 2025 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

Interoperability endpoints

  • Direct secure messaging: gfleenor2902465@carolinashealthcaresystem.direct-ci.com

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 1

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": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1023731148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-474-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 JUNIPER LN APT 623",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312207648",
            "telephone_number": "207-877-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Skowhegan",
            "state": "ME",
            "postal_code": "049761481",
            "country_code": "US",
            "telephone_number": "207-474-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENEDETTO",
        "first_name": "GABRIELLE",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.