Individual provider Active NPI

Jay S Gartner, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1093775611
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G6833 Issued in TX
Practice address
1918 Olive St Apt 2603
Dallas, TX 75201-2289
Phone
(214) 696-4270
Fax
(214) 696-1419
NPI assigned
Mar 27, 2006
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G6833 TX Primary

Addresses

Primary practice location

1918 Olive St Apt 2603
Dallas, TX 75201-2289

Mailing address

1918 Olive St Apt 2603
Dallas, TX 75201-2289
Phone (214) 696-4270

Other identifiers 1

IdentifierTypeStateIssuer
122879301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G6833TXMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1093775611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 OLIVE ST APT 2603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012289",
            "telephone_number": "214-696-4270",
            "fax_number": "214-696-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 OLIVE ST APT 2603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012289",
            "telephone_number": "214-696-4270",
            "fax_number": "214-696-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "JAY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G6833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122879301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.