Gabriela Maria Deoliveira, MD
Individual provider Active NPI Pediatrics Physician · Sault Sainte Marie, MI
NPI 1487230397 · NPPES record last updated Jul 3, 2024
Key facts
- NPI
- 1487230397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 4301511672 (MI)
- Practice address
- 550 Osborn Blvd
Ste 1006
Sault Sainte Marie, MI 49783 - Phone
- (906) 253-2665
- NPI assigned
- Mar 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240606000248 | MI | Practitioner - Pediatric Medicine | 9032512611 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301511672 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mymichigan Medical Center Sault | Current | Accepting new patients | |
| Mymichigan Medical Center Sault | Current |
Accepting new patients | |
| Mymichigan Medical Center Sault | Current |
Accepting new patients | |
| Mymichigan Medical Center Sault | Past | Accepting new patients |
Locations
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
550 Osborn Blvd
Ste 1006
Sault South Marie, MI 49783
Phone (906) 253-2665
500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350
Interoperability endpoints
- gdeoliveira83876@mymichiganhealth.midirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301511672 | MI | Yes |
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
Other providers in Sault Sainte Marie, MI
- Emma David
- Kayla Davis
- Kelly Dean
- Maryssa Lynn Delorey
- Rachel Denis
- Robert J Devers
- Louise Marie Dewey
- Chris Disano
- DLP Marquette Physician Practices Inc
- Joshua Doherty
All providers in Sault Sainte Marie, MI · Pediatrics Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.