Gabrielle Alyson Kobacker, FNP-C

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

CNP191153 Issued in ME

Practice address

17 Bishop St
Portland, ME 04103-2659

Phone

(207) 618-9611

NPI assigned

Jun 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bishop Medical Group LLCGroup PAC ID 6800298654, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Bishop Medical Group LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Portland, ME
  • NPI 1487256186
  Medicare reassignment Care Compare group NPD
• Bishop Health, LLC

  • Community/Behavioral Health Agency
  • South Portland, ME
  • NPI 1750037024
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1619538782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ELIJAH JAMES DR UNIT 101",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721685",
            "telephone_number": "207-907-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BISHOP ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032659",
            "telephone_number": "207-618-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBACKER",
        "first_name": "GABRIELLE",
        "middle_name": "ALYSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "ME",
            "license": "CNP191153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Knorr
• Sadie Jennings Knott, PMHNP
• Frank Alexander Knowles, LCSW
• Harry Knox III, ATC
• Lauren Ko, MD
• Catherine M Kobell, LCSW
• Anne L Koch, LCPC
• Cynthia Xiomara Koch
• Leah Koch
• Amy Kogut, CNM

• Addiction Medicine (Family Medicine) Physician in Portland, ME
• Providers in Portland, ME by specialty
• Addiction Medicine (Family Medicine) Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.