Individual provider Active NPI

Gloria Moussa-Gabour, M.D.

  • Family Medicine Physician
  • Melrose, MA
National Provider Identifier
1376505222
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76850 Issued in MA
Practice address
20 E Emerson St
Melrose, MA 02176-3521
Phone
(781) 979-4040
Fax
(781) 979-0808
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 76850 MA Primary

Addresses

Primary practice location

20 E Emerson St
Melrose, MA 02176-3521

Mailing address

20 E Emerson St
Melrose, MA 02176-3521
Phone (781) 979-4040

Other identifiers 4

IdentifierTypeStateIssuer
080050682OtherRAIL ROAD MEDICARE
3104206MedicaidMA
076850OtherMATUFTS HEALTH PLAN
70396OtherMAHPHC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519001035 MA Practitioner - Family Practice 5698716603 Practice locations: Melrose, MA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 E Emerson St
Melrose, MA 02176-3521
Phone (781) 979-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: gmoussagabour28811@tuftsmedicine.direct-ci.com

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1376505222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E EMERSON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763521",
            "telephone_number": "781-979-4040",
            "fax_number": "781-979-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E EMERSON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763521",
            "telephone_number": "781-979-4040",
            "fax_number": "781-979-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSSA-GABOUR",
        "first_name": "GLORIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "76850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "080050682",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3104206",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "076850",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "70396",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.