NPIMap

Individual provider Active NPI

Debra J Gazzuolo, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1548253347
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
SC23339 Issued in SC
Practice address
6115 Park South Dr Ste 100
Charlotte, NC 28210-3281
Phone
(704) 554-8787
Fax
(704) 554-8774
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X SC23339 SC Primary

Addresses

Primary practice location

6115 Park South Dr Ste 100
Charlotte, NC 28210-3281

Mailing address

6115 Park South Dr Ste 100
Charlotte, NC 28210-3281
Phone (704) 554-8787

Other identifiers 1

IdentifierTypeStateIssuer
233394MedicaidSC

Other names 1

  • Deborah J Gazzuolo Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140304000396 NC Practitioner - Internal Medicine 7517016314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare PLLCGroup PAC ID 3476678053, 15 clinicians

Practice addresses (Care Compare)

6115 Park S Dr
Suite 100
Charlotte, NC 28210-3269

6115 Park S Dr
Suite 100
Charlotte, NC 28210-3281
Phone (704) 554-8787

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
64.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SC23339SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare PLLC Internal Medicine CurrentSince Nov 20, 2013 Accepting new patients

Locations

6115 Park South Dr
Ste 100
Charlotte, NC 28210
Phone (704) 554-8787

Interoperability endpoints

  • Direct secure messaging: debra.gazzuolo.1@19260.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19260/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1548253347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103281",
            "telephone_number": "704-554-8787",
            "fax_number": "704-554-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103281",
            "telephone_number": "704-554-8787",
            "fax_number": "704-554-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZZUOLO",
        "first_name": "DEBRA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "SC23339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233394",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "GAZZUOLO",
            "middle_name": "J",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.