Jose R Gierbolini, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0048493 Issued in FL

Practice address

401 Venture Dr
South Daytona, FL 32119-3478

Phone

(386) 761-8888

Fax

(386) 760-8799

NPI assigned

Nov 17, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1579/brand/8/csg/141/fhir/r4
• Direct secure messaging: jose.gierbolini.1@1579.direct.athenahealth.com

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.

• Ormond Medical Arts Family Practice LLC

  dba Complete Health

  • Family Medicine Physician
  • Ormond Beach, FL
  • NPI 1326254962
  Medicare reassignment NPD

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1760464564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 VENTURE DR",
            "address_2": "SUITE A",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193478",
            "telephone_number": "386-761-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 VENTURE DR",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193478",
            "telephone_number": "386-761-8888",
            "fax_number": "386-760-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIERBOLINI",
        "first_name": "JOSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0048493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04494400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Ann Freeman, PT
• Veronica Fuentes
• Andrew Garber, M.S., LMFT, CHT
• Jill Denise Gerard, D. C.
• Bruce Ferrell Gibson
• Stephen Gilliam
• Gingras Chiropractic Clinic PA
• Frank Edwin Gingras, D.C.
• John Patrick Gingras, D.C.
• Michelle Lynn Gingras, D.C.

• Family Medicine Physician in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.