Fidelito Gabriel, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21464 Issued in MA

Practice address

63 Main St
Brockton, MA 02301-4042

Phone

(508) 559-6699

Fax

(508) 559-5073

NPI assigned

Jun 12, 2006

Sex

Male

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 MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: fgabriel19345@direct.ctc.masshiway.net

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.

• Brockton Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Brockton, MA
  • NPI 1225085319
  Medicare reassignment NPD
• Fidelito Gabriel DMD PC

  • General Practice Dentistry
  • Dorchester Center, MA
  • NPI 1376797241
  NPD (past) Authorized official
• Brockton Neighborhood Health Center, Inc.

  • Community/Retail Pharmacy
  • Brockton, MA
  • NPI 1528704061
  NPD
• Brockton Neighborhood Health Center

  • Community Health Clinic/Center
  • Brockton, MA
  • NPI 1255482139
  NPD (past)
• Gabriel Inc.

  • General Practice Dentistry
  • Dorchester Center, MA
  • NPI 1659558815
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1619919909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "617-763-9351",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "FIDELITO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulo M Fulton, MSW LICSW
• Alice F Furman, LICSW
• Jennifer Furtado
• Jennifer Fusco, APRN, FNP-BC
• Bassel Ahmed Kotb Gaballah
• Linda Gabruk
• Kimberly Gada, PT
• Rakshith Gadam, MD
• Raj A. Gadhia, M.D.
• Andrey Gagarin, M.D.

• General Practice Dentistry in Brockton, MA
• Providers in Brockton, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.