Individual provider Active NPI

Martin J Gabica, MD

  • Family Medicine Physician
  • Eagle, ID
National Provider Identifier
1801156351
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-3794 Issued in ID
Practice address
2323 E Buckskin CT
Eagle, ID 83616-2931
Phone
(208) 866-3913
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-3794 ID Primary

Addresses

Primary practice location

2323 E Buckskin CT
Eagle, ID 83616-2931

Mailing address

2323 E Buckskin CT
Eagle, ID 83616-2931
Phone (208) 866-3913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1801156351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 E BUCKSKIN CT",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836162931",
            "telephone_number": "208-866-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 E BUCKSKIN CT",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836162931",
            "telephone_number": "208-866-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABICA",
        "first_name": "MARTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-3794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.