Individual provider Active NPI

Timothy Mark Gabe, DMD

  • Endodontics
  • Boston, MA
National Provider Identifier
1194733956
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
15626 Issued in MA
Practice address
5 Longfellow Place
Suite 205
Boston, MA 02114
Phone
(617) 742-3525
Fax
(617) 742-6911
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 15626 MA Primary

Addresses

Primary practice location

5 Longfellow Place
Suite 205
Boston, MA 02114

Mailing address

5 Longfellow PL
Boston, MA 02114-2839
Phone (617) 742-3525

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151105002204 MA Order and Referring Only - Other (Non-Physician) 1254641004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Endodontics Endodontics Past Accepting new patients
Boston Endodontics Endodontics 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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1194733956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LONGFELLOW PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142839",
            "telephone_number": "617-742-3525",
            "fax_number": "617-742-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LONGFELLOW PLACE",
            "address_2": "SUITE 205",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-742-3525",
            "fax_number": "617-742-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABE",
        "first_name": "TIMOTHY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "15626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.