Gabriel Bakula Corvetto, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301500868 Issued in MI

Practice address

5656 W US Highway 10
Ludington, MI 49431-2454

Phone

(231) 843-2543

Fax

(231) 843-2547

NPI assigned

Jun 25, 2013

Last updated

Jun 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

General Surgery

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gbakulacorvetto707241@direct.trinity-health.org

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.

• Mercy Health Partners

  dba Trinity Health Medical Group

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  Medicare reassignment Care Compare group NPD
• Mercy Health Partners

  dba Trinity Health Medical Group Primary Care Whitehall

  • Rural Health Clinic/Center
  • Whitehall, MI
  • NPI 1326463357
  NPD
• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  NPD (past)

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

• Mercy Health Partners

  dba MHP - Lakeshore Campus

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1467892364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-672-2120",
            "fax_number": "231-728-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 W US HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312454",
            "telephone_number": "231-843-2543",
            "fax_number": "231-843-2547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Bevier St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "MI",
            "postal_code": "494551209",
            "country_code": "US",
            "telephone_number": "231-861-2187",
            "fax_number": "231-861-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-567-5711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 E Main St",
            "address_purpose": "LOCATION",
            "city": "Hart",
            "state": "MI",
            "postal_code": "494201190",
            "country_code": "US",
            "telephone_number": "231-873-6900",
            "fax_number": "231-873-1825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKULA CORVETTO",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301500868",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "4301500868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atkinson Emergency Physicians
• Erin Austin, RN
• Bret Gregory Autrey, D.O.
• Ralph Avedisian, DO
• Theresa Rene Baker
• Adam Ball, RN
• Julie Barber
• Susan M Barnhardt, PAC
• Lisa Baxter, MSW
• Kristi Ann Bearup, MSN, APRN, FNP-C

• Surgery Physician in Ludington, MI
• Providers in Ludington, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.