Ivonne Susana Gamboa, MD is a medicare enrolled "General Practice" physician in Jupiter, Florida. Her current practice location is
1094 Military Trl, Jupiter, Florida. You can reach out to her office (for appointments etc.) via phone at
(561) 622-6111.
Ivonne Susana Gamboa is licensed to practice in New Jersey (license number NJDCATEMP-037072) 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 1265020069.
Physician's Profile
Full Name | Ivonne Susana Gamboa |
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Gender | Female |
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Speciality | General Practice |
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Location | 1094 Military Trl, Jupiter, Florida |
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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: 1265020069
- Provider Enumeration Date: 01/06/2021
- Last Update Date: 03/31/2021
Medicare PECOS Information:
- PECOS PAC ID: 0749697035
- Enrollment ID: I20210405000320
Medical Identifiers
Medical identifiers for Ivonne Susana Gamboa such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1265020069 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 37767 (Oklahoma) | Secondary |
208D00000X | General Practice | NJDCATEMP-037072 (New Jersey) | 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. Ivonne Susana Gamboa allows following entities to bill medicare on her behalf.
Entity Name | The Medical Group Of South Florida Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1225179450 PECOS PAC ID: 8426079328 Enrollment ID: O20051207000504 |
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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. Ivonne Susana Gamboa 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 |
Ivonne Susana Gamboa, MD 1094 Military Trl, Jupiter, FL 33458-7021 Ph: (561) 622-6111 | Ivonne Susana Gamboa, MD 1094 Military Trl, Jupiter, FL 33458-7021 Ph: (561) 622-6111 |
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