Individual provider Active NPI

Gustavo Bacelar Fontenele Araujo, M.D.

  • Internal Medicine Physician
  • Vincenness, IN
National Provider Identifier
1578137246
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11022011A Issued in IN
Practice address
520 S. 7TH Street
Vincenness, IN 47591
Phone
(812) 885-8520
Fax
(812) 885-6991
NPI assigned
May 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 11022011A IN Primary

Addresses

Primary practice location

520 S. 7TH Street
Vincenness, IN 47591

Mailing address

12 Kimber Lane
Evansville, IN 47715
Phone (812) 304-7490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240718003675 IN Practitioner - Internal Medicine 6406259894 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc CurrentSince Jul 1, 2024 Accepting new patients
Deaconess Clinic, Inc Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Deaconess Clinic Inc. Internal Medicine Current Accepting new patients

Locations

520 Mary St
Ste 340
Evansville, IN 47710
Phone (812) 450-3201

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

Interoperability endpoints

  • Direct secure messaging: gustavo.araujo.1@7598.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1578137246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 KIMBER LANE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47715",
            "telephone_number": "812-304-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S. 7TH STREET",
            "city": "VINCENNESS",
            "state": "IN",
            "postal_code": "47591",
            "telephone_number": "812-885-8520",
            "fax_number": "812-885-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACELAR FONTENELE ARAUJO",
        "first_name": "GUSTAVO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11022011A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.