Individual provider Active NPI

Gabriela Maria Deoliveira, MD

  • Pediatrics Physician
  • Sault Sainte Marie, MI
National Provider Identifier
1487230397
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301511672 Issued in MI
Practice address
550 Osborn Blvd
Ste 1006
Sault Sainte Marie, MI 49783
Phone
(906) 253-2665
NPI assigned
Mar 22, 2021
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301511672 MI Primary

Addresses

Primary practice location

550 Osborn Blvd
Ste 1006
Sault Sainte Marie, MI 49783

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240606000248 MI Practitioner - Pediatric Medicine 9032512611 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301511672MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Sault Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince May 30, 2024 Accepting new patients
Mymichigan Medical Center Sault CurrentSince May 30, 2024 Accepting new patients
Mymichigan Medical Center Sault Past Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

550 Osborn Blvd
Ste 1006
Sault South Marie, MI 49783
Phone (906) 253-2665

Interoperability endpoints

  • Direct secure messaging: gdeoliveira83876@mymichiganhealth.midirect.net

Organizations & group practices 5

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1487230397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 OSBORN BLVD",
            "address_2": "STE 1006",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "49783",
            "telephone_number": "906-253-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEOLIVEIRA",
        "first_name": "GABRIELA",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-07-03",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301511672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.