Individual provider Active NPI

Naveen Gnanabakthan, MD

  • Hospitalist Physician
  • Vernon, CT
National Provider Identifier
1104267079
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
54659 Issued in CT
Practice address
31 Union Street
Rockville General Hospital
Vernon, CT 06066
Phone
(860) 533-6595
Fax
(860) 533-6594
NPI assigned
Jul 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 54659 CT Primary

Addresses

Primary practice location

31 Union Street
Rockville General Hospital
Vernon, CT 06066

Mailing address

1301 Solana Blvd BLDG. 2 Suite 2200
Sound Physicians
Westlake, TX 76262
Phone (817) 767-6115

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
I20210929001206 NY Practitioner - HospitalistPractitioner - Internal Medicine 3072807882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group, New York, PCGroup PAC ID 4587793294, 117 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219

Merit-based Incentive Payment System (MIPS)

Final score
86.4 of 100Reported as group
Quality
72.79
Improvement activities
40
Cost
71.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306748NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, New York, PC CurrentSince Aug 31, 2021 Accepting new patients
Erie County Medical Center Corporation Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

515 Main St
Olean, NY 14760
Phone (716) 373-2600

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 1

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104267079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SOLANA BLVD BLDG. 2 SUITE 2200",
            "address_2": "SOUND PHYSICIANS",
            "city": "WESTLAKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-767-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 UNION STREET",
            "address_2": "ROCKVILLE GENERAL HOSPITAL",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "06066",
            "telephone_number": "860-533-6595",
            "fax_number": "860-533-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNANABAKTHAN",
        "first_name": "NAVEEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "54659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

Verify at the official NPI Registry.