Michael John Gambello, MD, PHD

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

67568 Issued in GA

Practice address

2165 N Decatur Rd
Decatur, GA 30033-5307

Phone

(404) 778-8570

Fax

(404) 778-8562

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgambello60357@choa.gadirect.net
• Direct secure messaging: mgambello39361@direct.emory.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)
• The Emory Clinic Pediatric Providers

  • Pediatric Surgery Physician
  • Decatur, GA
  • NPI 1720285653
  NPD (past)
• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821
  NPD (past)
• Ut Physicians

  dba UT Health Services

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1386671394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 N DECATUR RD",
            "address_2": "EMORY CLINIC DEPARTMENT OF HUMAN GENETICS",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335307",
            "telephone_number": "404-778-8570",
            "fax_number": "404-778-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335307",
            "telephone_number": "404-778-8570",
            "fax_number": "404-778-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBELLO",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "GA",
            "license": "67568",
            "primary": true
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "TX",
            "license": "L3304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003122764A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "147519602",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147519602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8135N6",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Gaither, PHARMD
• Jessica Galison
• Benita Elaine Galloway, PHARM.D.
• Kevin Michael Galpin
• Hugo Alejandro Galvan, RBT
• Tara Gambill, DPT
• Antoinette Denise Gamble, N.P.
• Sara Lynn Gambone, CPNP-PC, APRN
• Bindiya Jay Gandhi, M.D.
• Dhaval Gandhi

• Clinical Genetics (M.D.) Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Genetics (M.D.) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.