Dr Rosvida Anne B San Gabriel, MD is a medicare enrolled "Pediatrics" physician in Streator, Illinois. Her current practice location is
104 W 6th St, Suite 303, Streator, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 673-2353.
Dr Rosvida Anne B San Gabriel is licensed to practice in Illinois (license number 036091951) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023166535.
Physician's Profile
Full Name | Dr Rosvida Anne B San Gabriel |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 104 W 6th St, Streator, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023166535
- Provider Enumeration Date: 01/08/2007
- Last Update Date: 12/30/2014
Medicare PECOS Information:
- PECOS PAC ID: 7214393784
- Enrollment ID: I20230525002659
Medical Identifiers
Medical identifiers for Dr Rosvida Anne B San Gabriel such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023166535 | NPI | - | NPPES |
036091951 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 036091951 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Rosvida Anne B San Gabriel allows following entities to bill medicare on her behalf.
Entity Name | Riverside Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417061193 PECOS PAC ID: 3274434717 Enrollment ID: O20040116000780 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Rosvida Anne B San Gabriel is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Rosvida Anne B San Gabriel, MD 104 W 6th St, Suite 303, Streator, IL 61364-2899 Ph: (815) 673-2353 | Dr Rosvida Anne B San Gabriel, MD 104 W 6th St, Suite 303, Streator, IL 61364-2899 Ph: (815) 673-2353 |
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