Individual provider Active NPI

Gabriella Elise Martin, DO

  • Student in an Organized Health Care Education/Training Program
  • Miami, FL
National Provider Identifier
1063265718
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
15955 SW 96TH St Ste 200
Miami, FL 33196-1272
Phone
(786) 467-3140
NPI assigned
Apr 10, 2024
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

15955 SW 96TH St Ste 200
Miami, FL 33196-1272

Mailing address

10644 NW 68TH CT
Parkland, FL 33076-2963
Phone (954) 805-7232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240725000311 FL Order and Referring Only - Family PracticePractitioner - Family Practice 3577009653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Physicians LLC CurrentSince Apr 14, 2024 Accepting new patients

Locations

15955 SW 96th St
Ste 200
Miami, FL 33196
Phone (786) 467-3140

Interoperability endpoints

  • Direct secure messaging: gabriella.martin.1@27920.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1063265718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10644 NW 68TH CT",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330762963",
            "telephone_number": "954-805-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15955 SW 96TH ST STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331961272",
            "telephone_number": "786-467-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GABRIELLA",
        "middle_name": "ELISE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.