GABRIELLE DOMENICA FAZIO FNP-BC
NPI 1104520360
Nurse Practitioner - Family in San Diego, CA

Q: What is Gabrielle Fazio's NPI number?

The NPI number for Gabrielle Fazio is 1104520360. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Q: What is Gabrielle Fazio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Gabrielle Fazio was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2023PECOS EnrolledAccepts Medicare Assignment

5651 COPLEY DR, SAN DIEGO, CA 92111(858) 262-6070 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 27, 2026, Apr 9, 2024, Jun 5, 2023 and 2 more (5 updates tracked since 2023).

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About Gabrielle Domenica Fazio Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GABRIELLE DOMENICA FAZIO FNP-BC (NPI 1104520360) is an individual family provider in San Diego, California, licensed in Michigan (4704326001) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, is affiliated with Mclaren Oakland, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1104520360

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameGABRIELLE DOMENICA FAZIOCredential: FNP-BC

Location Address5651 COPLEY DRSan Diego, CA 92111-7903

Mailing Address5651 Copley DrSan Diego, CA 92111-7903 · (858) 262-6070

Phone(858) 262-6070

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 29, 2023

Last NPPES UpdateMarch 27, 20265 updates tracked since enumeration

NPPES CertifiedMarch 27, 2026

✔ NPI 1104520360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · 4704326001

5651 COPLEY DR, San Diego, CA 92111

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gabrielle Domenica Fazio Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931569795

PECOS Enrollment IDI20230712002893, I20260514003155

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

129 services121 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

41 services41 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mclaren Oakland

Acute Care Hospitals · Pontiac, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230207

Location50 N Perry StPontiac, MI 48342 · Oakland County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARP HEALTHCARE

Clinical Medical Laboratory