Individual provider Active NPI

Dianne Brewer Gasbarra, MD

  • Pulmonary Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1225020282
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
13952 Issued in OK
Practice address
4200 W Memorial Rd
Ste 405
Oklahoma City, OK 73120-9350
Phone
(405) 292-5500
Fax
(405) 292-5505
NPI assigned
Aug 16, 2005
Last updated
Nov 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 13952 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd
Ste 405
Oklahoma City, OK 73120-9350

Mailing address

4200 W Memorial Rd
Ste 405
Oklahoma City, OK 73120-9350
Phone (405) 292-5500

Other identifiers 2

IdentifierTypeStateIssuer
10002019OAMedicaidOK
P00149574OtherOKRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040728000157 OK Practitioner - Pulmonary Disease 9537063391

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13952OKMDPharmacist

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1225020282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "STE 405",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-292-5500",
            "fax_number": "405-292-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "STE 405",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-292-5500",
            "fax_number": "405-292-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASBARRA",
        "first_name": "DIANNE",
        "middle_name": "BREWER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OK",
            "license": "13952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10002019OA",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00149574",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.