Mark Mahamoud Gabriel, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5070 Issued in OR

Practice address

1359 NE 35TH Ave.
Portland, OR 97232

Phone

(503) 389-5545

NPI assigned

Jul 12, 2011

Last updated

Sep 26, 2014By 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 OR

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Wellness Center LLCGroup PAC ID 8123398526, 4 clinicians

Renovo Chiropractic LLCGroup PAC ID 9436491156, 3 clinicians

Practice addresses (Care Compare)

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.

State licenses

Practice roles

Locations

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.

• Advanced Wellness Center LLC

  dba The Wellness Center PDX

  • Chiropractor
  • Portland, OR
  • NPI 1245632447
  Medicare reassignment Care Compare group Authorized official
• Renovo Chiropractic LLC

  • Clinic/Center
  • Lincoln City, OR
  • NPI 1710442751
  Medicare reassignment Care Compare group NPD
• Advanced Wellness Center

  dba The Advanced Wellness Center PDX

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1275921660
  NPD Authorized official
• Medical Wellness Care

  • Acupuncturist
  • Portland, OR
  • NPI 1922484401
  Authorized official Same address or phone

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1538457585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 NE 35TH AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-389-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 NE 35TH AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-389-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "MARK",
        "middle_name": "MAHAMOUD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5070",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10350",
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Gaboury
• Cynthia Lou Gaboury, MD
• Ahmed Gabr, MD
• Alexa Gabriel
• Marcus Quinton Gabriel Jr., PNP
• Maura Riordan Gabriel, PT
• Paolo Pilar Gabriel, M.D.
• Monika Clare Gabriele, MD
• Faith Danette Gabrielson, LPTA
• Zoe Quinn Gabrielson

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.