Individual provider Active NPI

Gail Mindy Libowsky, NP

  • Adult Health Nurse Practitioner
  • Watertown, MA
National Provider Identifier
1255390019
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
143806 Issued in MA
Practice address
485 Arsenal St
Watertown, MA 02472-5091
Phone
(617) 982-5100
Fax
(617) 972-5439
NPI assigned
Mar 21, 2006
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 143806 MA
Adult Health Nurse Practitioner 363LA2200X 143806 MA Primary

Addresses

Primary practice location

485 Arsenal St
Watertown, MA 02472-5091

Mailing address

485 Arsenal St
Watertown, MA 02472-5091
Phone (617) 972-5100

Other identifiers 1

IdentifierTypeStateIssuer
NP2001OtherMABLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glibowskynp3954@direct.atrius.masshiway.net

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000691 MA Practitioner - Nurse Practitioner 4183648892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

485 Arsenal St
Watertown, MA 02472-5091
Phone (617) 972-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
143806MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Nurse Practitioner CurrentSince Sep 9, 1999 Accepting new patients
Atrius Health, Inc. Nurse Practitioner Current Accepting new patients
Atrius Health, Inc. CurrentSince Sep 9, 1999 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

485 Arsenal St
Watertown, MA 02472
Phone (617) 972-5100

Organizations & group practices 3

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1255390019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024725091",
            "telephone_number": "617-972-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024725091",
            "telephone_number": "617-982-5100",
            "fax_number": "617-972-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBOWSKY",
        "first_name": "GAIL",
        "middle_name": "MINDY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "143806",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "143806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP2001",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glibowskynp3954@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "485 Arsenal St",
            "city": "Watertown",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024725091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.