| Michael Domenic Defabrizio, | |
|
49 Harry Kemp Way, Provincetown, MA 02657-1618 | |
| (508) 487-9395 | |
| (508) 487-6298 |
| Full Name | Michael Domenic Defabrizio |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 49 Harry Kemp Way, Provincetown, Massachusetts |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568013175 | NPI | - | NPPES |
| 123517200 | Medicaid | FL | |
| 110156991A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APRN11026323 (Florida) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN2301292 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Holy Cross Hospital | Fort lauderdale, FL | Hospital |
| Cape Cod Healthcare | Hyannis, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Holy Cross Hospital Inc | 1850298365 | 305 |
| Outer Cape Health Services Inc | 4385554971 | 50 |
| Lifebridge Sports Medicine And Rehabilitation Llc | 4385787910 | 31 |
| Outer Cape Health Services Inc | 4385554971 | 50 |
| Entity Name | Holy Cross Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467401877 PECOS PAC ID: 1850298365 Enrollment ID: O20031215000087 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Domenic Defabrizio, Po Box 2796, Orleans, MA 02653-6796 Ph: (508) 487-9395 | Michael Domenic Defabrizio, 49 Harry Kemp Way, Provincetown, MA 02657-1618 Ph: (508) 487-9395 |
Maria Coyne, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 49 Harry Kemp Way, Provincetown, MA 02657 Phone: 508-487-9395 | |
Maryanne O'toole, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 49 Harry Kemp Way, Provincetown, MA 02657 Phone: 508-487-9395 Fax: 508-487-3285 | |
Mrs. Susan H. Roderick, CFNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 49 Harry Kemp Way, Outer Cape Health, Provincetown, MA 02657 Phone: 508-487-9395 Fax: 508-487-3285 | |
Christy Braga De Lima, REGISTERED NURSE Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 49 Harry Kemp Way, Provincetown, MA 02657 Phone: 508-487-9395 Fax: 508-487-6298 | |
Dr. Thomas Jude Mcquaid, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 286a Bradford St Unit 9, Provincetown, MA 02657 Phone: 917-566-3554 Fax: 203-274-6713 | |
Mr. Frank D. Bellistri, NP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 26 Court St Unit 4, Provincetown, MA 02657 Phone: 508-444-9966 Fax: 617-245-4619 |