Eric Alan Gantwerker, MD, MMSC(MEDED)

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

307859 Issued in NY

Practice address

430 Lakeville Rd
New Hyde Park, NY 11042-1121

Phone

(718) 470-7550

NPI assigned

Jun 26, 2008

Last updated

Mar 10, 2022By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: egantwerker29039@northwell.direct-ci.com

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Otolaryngology

  Medicare reassignment NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Long Island Jewish Medical Center

  dba Steven & Alexandra Cohen Children's Medical Center of New York

  • Children's Hospital
  • New Hyde Park, NY
  • NPI 1174530349
  NPD (past)
• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1144482662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421121",
            "telephone_number": "718-470-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421121",
            "telephone_number": "718-470-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTWERKER",
        "first_name": "ERIC",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD, MMSC(MEDED)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2022-03-10",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NY",
            "license": "307859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamala Gandhi, M.D.
• Stacey Sailesh Gandhi, M.D.
• Kelly Ann Gannon, OTR/L
• Laurent Ganry
• Mitchell Gantman, OPTICIAN
• Kaitlyn Elizabeth Gantwerker, AUD
• Ziwei Gao
• Luke Garbarino, MD
• Lyndsey Rubin Garbi, M.D.
• Ingris Garcia, RDN, CDN

• Pediatric Otolaryngology Physician in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Pediatric Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.