Mary Parish Gavinski, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

26129 Issued in WI

Practice address

205 Bishops Way
Brookfield, WI 53005-6247

Phone

(262) 207-9318

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Alice Parish Gavinski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1235229568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BISHOPS WAY",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056247",
            "telephone_number": "262-207-9318",
            "fax_number": "414-672-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BISHOPS WAY",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056247",
            "telephone_number": "262-207-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVINSKI",
        "first_name": "MARY",
        "middle_name": "PARISH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "26129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ALICE",
            "last_name": "GAVINSKI",
            "middle_name": "PARISH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Geriatric Medicine (Internal Medicine) Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Geriatric Medicine (Internal Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.