Individual provider Active NPI

Tina Marie Gebarowski, N.P.

  • Gerontology Nurse Practitioner
  • Milford, MA
National Provider Identifier
1053640607
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
236502 Issued in MA
Practice address
1 Countryside Dr
Milford, MA 01757-1252
Phone
(508) 473-0435
Fax
(508) 473-9755
NPI assigned
Dec 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 236502 MA Primary

Addresses

Primary practice location

1 Countryside Dr
Milford, MA 01757-1252

Mailing address

1 Countryside Dr
Milford, MA 01757-1252
Phone (508) 473-0435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20161006001684 MA Practitioner - Nurse Practitioner 9032333794 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England, P.C. Gerontology Current Accepting new patients
Ipc Hospitalists of New England, P.C. Gerontology CurrentSince Sep 12, 2016 Accepting new patients
Ipc Hospitalists of New England PC CurrentSince Sep 12, 2016 Accepting new patients
Wellesley Primary Care Medicine, PC CurrentSince Jun 19, 2017 Accepting new patients

Locations

1 Countryside Dr
Milford, MA 01757
Phone (508) 473-0435

67 Union St
Natick, MA 01760
Phone (508) 383-1104

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

819 Worcester St
Ste 3
Springfield, MA 01151
Phone (413) 543-6820

65 Walnut St
Ste 500
Wellesley Hills, MA 02481
Phone (781) 431-2345

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1053640607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COUNTRYSIDE DR",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571252",
            "telephone_number": "508-473-0435",
            "fax_number": "508-473-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COUNTRYSIDE DR",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571252",
            "telephone_number": "508-473-0435",
            "fax_number": "508-473-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBAROWSKI",
        "first_name": "TINA MARIE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "236502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.