Individual provider Active NPI

Gabriel Colon Caballero, MD

  • Internal Medicine Physician
  • Sebastian, FL
National Provider Identifier
1114220886
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME163738 Issued in FL
Practice address
801 Wellness Way Ste 200
Sebastian, FL 32958-3783
Phone
(855) 505-7467
Fax
(888) 975-8926
NPI assigned
Dec 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A150114 CA
Internal Medicine Physician 207R00000X ME163738 FL Primary

Addresses

Primary practice location

801 Wellness Way Ste 200
Sebastian, FL 32958-3783

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862

Other identifiers 1

IdentifierTypeStateIssuer
1114220886MedicaidCA

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
I20230901001253 FL Practitioner - Internal Medicine 3375814080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

801 Wellness Way
Suite 200
Sebastian, FL 32958-3783
Phone (772) 558-1558

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A150114CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Oct 16, 2023 Accepting new patients
Indian River Health Services Inc CurrentSince Oct 16, 2023 Accepting new patients
Indian River Health Services Inc Internal Medicine Past Accepting new patients

Locations

801 Wellness Way
Ste 200
Sebastian, FL 32958
Phone (772) 558-1558

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1114220886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 WELLNESS WAY STE 200",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583783",
            "telephone_number": "855-505-7467",
            "fax_number": "888-975-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON CABALLERO",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-17",
        "last_updated": "2023-10-25",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A150114",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME163738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114220886",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

Verify at the official NPI Registry.