NPIMap

Organization Active NPI

Gary a. Fantini, M.D., PLLC

  • Specialist
  • New York, NY
National Provider Identifier
1104248517
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
161192-1 Issued in NY
Legal business name
GARY A. FANTINI, M.D., PLLC
Practice address
535 E 70TH St
New York, NY 10021-4823
Phone
(212) 606-1427
Fax
(212) 774-7175
NPI assigned
Jan 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Authorized official

Name
Mrs. Maria Cabeza
Title
Office Manager
Phone
(212) 606-1427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 161192-1 NY Primary

Addresses

Primary practice location

535 E 70TH St
New York, NY 10021-4823

Mailing address

535 E 70TH St
New York, NY 10021-4823
Phone (212) 606-1427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140224000840 NY Part B Supplier - Clinic/Group Practice 4789814526 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

535 E 70th St
#Hospi
New York, NY 10021
Phone (212) 249-5411

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1104248517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-606-1427",
            "fax_number": "212-774-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-606-1427",
            "fax_number": "212-774-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY A. FANTINI, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "CABEZA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "212-606-1427",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "161192-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.