George Jeffrey Gavern, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

054089 Issued in CT

Practice address

Nvra Business Office
385 Main St South
Southbury, CT 06488

Phone

(203) 264-7999

Fax

(203) 264-7477

NPI assigned

Jun 5, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Diagnostic Radiology

Education

Philadelphia College of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Naugatuck Valley MRI LLCGroup PAC ID 2668367756, 7 clinicians

Diagnostic Imaging Associates LLCGroup PAC ID 0143127241, 10 clinicians

Prospect Diagnostic ImagingGroup PAC ID 0244137214, 10 clinicians

Diagnostic Imaging of SouthburyGroup PAC ID 0143127548, 11 clinicians

Naugatuck Valley Radiological Associates PCGroup PAC ID 5092600189, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
• Griffin Hospital Hospital, Derby, CT, CCN 070031
• Waterbury Hospital Hospital, Waterbury, CT, CCN 070005
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Diagnostic Imaging Associates LLC

  • Radiology Clinic/Center
  • Waterbury, CT
  • NPI 1336161918
  Medicare reassignment Care Compare group NPD
• Diagnostic Imaging of Southbury

  • Radiology Clinic/Center
  • Southbury, CT
  • NPI 1245252824
  Medicare reassignment Care Compare group NPD
• Prospect Diagnostic Imaging

  • Radiology Clinic/Center
  • Prospect, CT
  • NPI 1154343739
  Medicare reassignment Care Compare group NPD
• Naugatuck Valley MRI LLC

  • Diagnostic Radiology Physician
  • Waterbury, CT
  • NPI 1134141716
  Medicare reassignment Care Compare group
• Naugatuck Valley Radiological Associates PC

  • Diagnostic Radiology Physician
  • Waterbury, CT
  • NPI 1114949799
  Medicare reassignment Care Compare group
• Naugatuck Valley Computerized Imaging

  • Radiology Clinic/Center
  • Waterbury, CT
  • NPI 1225050800
  NPD (past)

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

• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Care Compare affiliation
• Saint Mary'S Hospital, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1760426969
  Care Compare affiliation
• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1275696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1073833612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NVRA BUSINESS OFFICE",
            "address_2": "385 MAIN ST SOUTH",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NVRA BUSINESS OFFICE",
            "address_2": "385 MAIN ST SOUTH",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVERN",
        "first_name": "GEORGE",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-05",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "054089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIS",
            "identifier": "D400227516",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PDI",
            "identifier": "D400227523",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVRA",
            "identifier": "D400227521",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MRI",
            "identifier": "D400227511",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIA",
            "identifier": "D400227517",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggavern225440@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "NVRA BUSINESS OFFICE",
            "address_2": "385 MAIN ST SOUTH",
            "city": "SOUTHBURY",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Diagnostic Radiology Physician in Southbury, CT
• Providers in Southbury, CT by specialty
• Diagnostic Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.