NPIMap

Individual provider Active NPI

Jacqueline F Fabello-Gamiao, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Livonia, MI
National Provider Identifier
1144208232
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301060039 Issued in MI
Practice address
37650 Professional Center Dr
Suite 100a
Livonia, MI 48154-1197
Phone
(734) 462-1940
Fax
(734) 462-1960
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301060039 MI Primary

Addresses

Primary practice location

37650 Professional Center Dr
Suite 100a
Livonia, MI 48154-1197

Mailing address

37650 Professional Center Dr
Suite 100a
Livonia, MI 48154-1197
Phone (734) 462-1940

Other names 1

  • Dr. Jacqueline F Fabello Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050302000953 MI Practitioner - EndocrinologyPractitioner - Internal Medicine 3375596216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

37650 Professional Ctr Dr
100A
Livonia, MI 48154-1199
Phone (734) 462-1940

Hospital & facility affiliations

  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301060039MIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ghaida Khodher MD PC Past Accepting new patients

Organizations & group practices 2

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1144208232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 100A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541197",
            "telephone_number": "734-462-1940",
            "fax_number": "734-462-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 100A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541197",
            "telephone_number": "734-462-1940",
            "fax_number": "734-462-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABELLO-GAMIAO",
        "first_name": "JACQUELINE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301060039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "FABELLO",
            "middle_name": "F",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.