Roger Gabriel, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25 Issued in WI

Practice address

2901 W Kinnickinnic River Pkwy
#310
Milwaukee, WI 53215-3677

Phone

(414) 649-3990

Fax

(414) 649-3969

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)
• Cardiovascular Surgery Associates S.C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Milwaukee, WI
  • NPI 1790718237
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366421133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "#310",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-649-3990",
            "fax_number": "414-649-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "#310",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153677",
            "telephone_number": "414-649-3990",
            "fax_number": "414-649-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "ROGER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42929700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Jean Gaalaas, M.S. O.T.R.
• Shelly Gaatz
• Dee A Gabbard, RD
• Makenna Mary Gabel
• Ronald Edward Gabel, PA
• Sofia Gabrilovich, M.D.
• Paula Ann Gabrish, LPN
• Yekta Victoria Gadbois, MD
• Anna Gaddy, M.D.
• Jessica Rose Gaddy, APNP

• All providers in Milwaukee, WI
• Surgical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.