GARY W GIBBONS (NPI# 1558322040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558322040 |
| Entity Type | Individual |
| Full Name | GARY W GIBBONS |
| Credential | MD |
| Practice Address |
732 Harrison Ave Preston 2 Boston MA 02118-2656 |
| Practice Telephone | 6174146840 |
| Practice Fax Number | 6174146710 |
| Mailing Telephone | 6174146840 |
| Mailing Fax Number | 6174146710 |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2017-03-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
34791 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 2016621 | 05 |
| Street Address |
732 HARRISON AVE PRESTON 2 |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336146810 | Hans K Meier-ewert | Internal Medicine | 732 Harrison Ave, Preston Building - 3rd Floor, Boston, MA 02118-2309 | 2005-06-30 |
| 1972144236 | Christina Ann Guerriero | Physician Assistant | 732 Harrison Ave, Preston 2nd Fl, Boston, MA 02118 | 2019-10-07 |
| 1861045478 | Kristen Fein | Nurse Practitioner | 732 Harrison Ave, 3rd Floor, Boston, MA 02118 | 2019-07-23 |
| 1730732314 | Oluwakemi Olotu | Family Medicine | 732 Harrison Ave, Fl 3, Boston, MA 02118 | 2019-07-22 |
| 1174082143 | Ashley Dinah Daniel | Student in an Organized Health Care Education/Training Program | 732 Harrison Ave, Boston, MA 02118-2309 | 2019-03-18 |
| 1023522497 | Tram T Tran | Nurse Practitioner | 732 Harrison Ave, Preston, 2nd Floor, Boston, MA 02118 | 2017-11-21 |
| 1083127658 | Lorely Torres | Nurse Practitioner | 732 Harrison Ave, Preston, 2nd Floor, Boston, MA 02118 | 2017-11-06 |
| 1093246951 | Heidi Michelle Fuller | Student in an Organized Health Care Education/Training Program | 732 Harrison Ave, Podiatry Clinic 5th Floor, Boston, MA 02118-2309 | 2017-03-22 |
| 1407306731 | Colin Flynn | Physician Assistant | 732 Harrison Ave, Preston, 3rd Floor, Boston, MA 02118-2309 | 2016-10-11 |
| 1639627649 | Jessica Nicole Fernandes | Physician Assistant | 732 Harrison Ave, Preston, 3rd Floor, Boston, MA 02118-2309 | 2016-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255563334 | Samuel Schwartz | Surgery | 15 Parkman St # 440, Boston, MA 02114-3117 | 2009-08-21 |
| 1609921345 | John A Mannick | Surgery | Brigham & Womens Hosp, 75 Francis Street, Boston, MA 02115 | 2007-01-24 |
| 1326093733 | Sherry D Scovell | Surgery | 15 Parkman Street Wac 440, Massachusetts General Hospital Division of Vascular Sur, Boston, MA 02114 | 2006-05-23 |
| 1831155985 | Matthew T Menard | Surgery | Brigham and Womans Hospital, Division of Vascular Surgery, Boston, MA 02115 | 2006-04-25 |
| 1174158109 | Mohamad Anas Hussain | Surgery | 75 Francis St, Boston, MA 02115-6106 | 2020-03-10 |
| 1477027464 | Julie E Mosher | Surgery | 55 Fruit St, Boston, MA 02114-2621 | 2019-01-14 |
| 1346770583 | Srihari K Lella | Surgery | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2017-06-19 |
| 1447609235 | Jennifer Li | Surgery | 110 Francis St, Suite 9b, Boston, MA 02215-5501 | 2016-06-13 |
| 1700227311 | Anand Yogesh Shah | Surgery | 800 Washington St # 437, Boston, MA 02111-1552 | 2013-07-11 |
| 1497015507 | Aqeel M Siddiqui Md Ltd | Surgery | 4 Longfellow Pl, 3406, Boston, MA 02114-2838 | 2012-05-22 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.