Individual provider Active NPI

Frank Gibase, M.D.

  • Anesthesiology Physician
  • Vidalia, GA
National Provider Identifier
1194718494
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
040075 Issued in GA
Practice address
1 Meadows Pkwy
Vidalia, GA 30474-8759
Phone
(912) 538-5359
Fax
(912) 538-5228
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 040075 GA Primary

Addresses

Primary practice location

1 Meadows Pkwy
Vidalia, GA 30474-8759

Mailing address

PO Box 1303
Vidalia, GA 30475-1303
Phone (912) 538-5359

Other identifiers 1

IdentifierTypeStateIssuer
000656807BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100914000092 GA Practitioner - Anesthesiology 4486697018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Vanderbilt University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

1 Meadows Pkwy
Vidalia, GA 30474-8759
Phone (912) 535-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040075GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SE Georgia Anesthesia, LLC Anesthesiology CurrentSince Apr 15, 2021 Accepting new patients

Locations

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

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 and National Provider Directory roles.

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1194718494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1303",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304751303",
            "telephone_number": "912-538-5359",
            "fax_number": "912-538-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEADOWS PKWY",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748759",
            "telephone_number": "912-538-5359",
            "fax_number": "912-538-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBASE",
        "first_name": "FRANK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "040075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000656807B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.