Individual provider Active NPI

Peter Gerard Gasparo, M.D.

  • Psychiatry Physician
  • Stockton, CA
National Provider Identifier
1114188869
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G71424 Issued in CA
Practice address
7707 Austin Rd
Stockton, CA 95215-8312
Phone
(203) 952-2773
NPI assigned
Jun 24, 2008
Last updated
Dec 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 180840-1 NY
Psychiatry Physician 2084P0800X MD-19542-0 HI
Psychiatry Physician 2084P0800X 041726 CT
Psychiatry Physician 2084P0800X C1-0023937 DE
Psychiatry Physician 2084P0800X ME119950 FL
Psychiatry Physician 2084P0800X G71424 CA Primary

Addresses

Primary practice location

7707 Austin Rd
Stockton, CA 95215-8312

Mailing address

PO Box 909
Ridgefield, CT 06877-8909
Phone (203) 952-2773

Other practice location 1

78 Triangle St
Danbury, CT 06810-6977
Phone (619) 925-5257

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090223000132 CT Practitioner - Psychiatry 5294890430 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71424CAMDPsychiatry Physician
041726CTMDPsychiatry Physician
C1-0023937DEMDPsychiatry Physician
ME119950FLMDPsychiatry Physician
MD-19542-0HIMDPsychiatry Physician
180840-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Mar 4, 2016 Accepting new patients
State of Connecticut CurrentSince Mar 4, 2016 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500

249 Winsted Rd
Fl 3
Torrington, CT 06790
Phone (860) 496-3700

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

Interoperability endpoints

  • Direct secure messaging: peterg.gasparo@xdr.hhchealthdirect.org
  • Direct secure messaging: pgasparo@direct.health-quest.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1114188869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068778909",
            "telephone_number": "203-952-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 AUSTIN RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952158312",
            "telephone_number": "203-952-2773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Triangle St",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106977",
            "country_code": "US",
            "telephone_number": "619-925-5257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASPARO",
        "first_name": "PETER",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "180840-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-19542-0",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "041726",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0023937",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME119950",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G71424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.