Individual provider Active NPI

Gary Bartholomew Gugliada, DPM

  • Foot Surgery Podiatrist
  • Staten Island, NY
National Provider Identifier
1184699795
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
N0048921 Issued in NY
Practice address
89 Cromwell Ave
Staten Island, NY 10304-3944
Phone
(718) 980-0126
Fax
(718) 980-9252
NPI assigned
Feb 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X N0048921 NY Primary

Addresses

Primary practice location

89 Cromwell Ave
Staten Island, NY 10304-3944

Mailing address

89 Cromwell Ave
Staten Island, NY 10304-3944
Phone (718) 980-0126

Other identifiers 1

IdentifierTypeStateIssuer
01425227MedicaidNY

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
I20070524000068 NY Practitioner - Podiatry 3476650516 Reassigns benefits to 1 organization
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Staten Island Podiatry PCGroup PAC ID 3678667326, 2 clinicians

Practice addresses (Care Compare)

364 Edison St
Staten Island, NY 10306-3041
Phone (718) 524-4112

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue430
Removal or shaving of skin growth18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004892NYMDMental Health Counselor
N0048921NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Staten Island Podiatry, P.C. CurrentSince May 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ggugliada218634@northwell.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1184699795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CROMWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043944",
            "telephone_number": "718-980-0126",
            "fax_number": "718-980-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 CROMWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043944",
            "telephone_number": "718-980-0126",
            "fax_number": "718-980-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGLIADA",
        "first_name": "GARY",
        "middle_name": "BARTHOLOMEW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-18",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N0048921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01425227",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.