Individual provider Active NPI

Michael Joseph Gastaldi, DDS

  • Dentist
  • Staten Island, NY
National Provider Identifier
1164561387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
042127 Issued in NY
Practice address
86 McClean Ave
Staten Island, NY 10305-4612
Phone
(718) 816-6686
Fax
(718) 720-4966
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042127 NY Primary

Addresses

Primary practice location

86 McClean Ave
Staten Island, NY 10305-4612

Mailing address

86 McClean Ave
Staten Island, NY 10305-4612
Phone (718) 816-6686

Other names 1

  • Dr. Michael Joseph Gastaldi Professional name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150523000006 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9638499114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042127NYMDDentist

Interoperability endpoints

  • Direct secure messaging: mgastaldi51523@northwell.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164561387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 MCCLEAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054612",
            "telephone_number": "718-816-6686",
            "fax_number": "718-720-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 MCCLEAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054612",
            "telephone_number": "718-816-6686",
            "fax_number": "718-720-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTALDI",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "GASTALDI",
            "middle_name": "JOSEPH",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.