Individual provider Active NPI

Daniel Horacio Wasserman

  • Gastroenterology Physician
  • Forest Hills, NY
National Provider Identifier
1023154069
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
170615-1 Issued in NY
Practice address
11203 Queens Blvd
Suite 207
Forest Hills, NY 11375-5550
Phone
(718) 544-7077
Fax
(718) 261-4476
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 170615-1 NY Primary

Addresses

Primary practice location

11203 Queens Blvd
Suite 207
Forest Hills, NY 11375-5550

Mailing address

11203 Queens Blvd
Suite 207
Forest Hills, NY 11375-5550
Phone (718) 544-7077

Other identifiers 1

IdentifierTypeStateIssuer
01078399MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000299 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 3779646856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

9777 Queens Blvd
Rego Park, NY 11374-3335
Phone (718) 261-9100

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy179
Upper gastrointestinal (GI) endoscopy for acid reflux130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
170615-1NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 1, 2024 Accepting new patients
New York University Gastroenterology CurrentSince Apr 1, 2024 Accepting new patients

Locations

11203 Queens Blvd
Ste 207
Forest Hills, NY 11375
Phone (718) 263-3718

9777 Queens Blvd
Rego Park, NY 11374
Phone (718) 275-9300

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: dwasserman436885@nyumc.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023154069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 QUEENS BLVD",
            "address_2": "SUITE 207",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755550",
            "telephone_number": "718-544-7077",
            "fax_number": "718-261-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 QUEENS BLVD",
            "address_2": "SUITE 207",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755550",
            "telephone_number": "718-544-7077",
            "fax_number": "718-261-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "DANIEL",
        "middle_name": "HORACIO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "170615-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01078399",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.