Individual provider Active NPI

Gina Marangoni Gabriel, OD MS

  • Optometrist
  • Longmont, CO
National Provider Identifier
1902889637
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2529 Issued in CO
Practice address
2080 N Main St
Longmont, CO 80501-1916
Phone
(303) 651-2020
Fax
(303) 776-2460
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5473 OH
Optometrist 152W00000X 2529 CO Primary

Addresses

Primary practice location

2080 N Main St
Longmont, CO 80501-1916

Mailing address

2080 N Main St
Longmont, CO 80501-1916
Phone (303) 651-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20061221000046 CO Practitioner - Optometry 2961401948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optometric Associates PCGroup PAC ID 0345131033, 6 clinicians

Practice addresses (Care Compare)

2080 Main St
Longmont, CO 80501-1916
Phone (303) 772-2755

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2529COMDClinical Psychologist
5473OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Associates PC Optometrist CurrentSince Aug 21, 2006 Accepting new patients

Locations

2080 Main St
Longmont, CO 80501
Phone (303) 651-2020

Organizations & group practices 1

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1902889637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 N MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011916",
            "telephone_number": "303-651-2020",
            "fax_number": "303-776-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 N MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011916",
            "telephone_number": "303-651-2020",
            "fax_number": "303-776-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "GINA",
        "middle_name": "MARANGONI",
        "name_prefix": "Dr.",
        "credential": "OD MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5473",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.