Active NPI
Abhilash Gazula, MD
- Student in an Organized Health Care Education/Training Program
- Albany, NY
National Provider Identifier
1215515697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 64449
- Practice address
- 47 New Scotland Avenue
Dept. of Pediatrics
Albany, NY 12208 - Phone
- (518) 262-5626
- NPI assigned
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 64449 | NY | Primary |
Addresses
Primary practice location
47 New Scotland Avenue
Dept. of Pediatrics
Albany, NY 12208
Mailing address
47 New Scotland Avenue
Dept. of Pediatrics
Albany, NY 12208
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64449 | NY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical Center Hospital | Past | Accepting new patients |
Locations
47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773
1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705
Interoperability endpoints
- agazula19379@albanymed.direct-ci.com
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 and National Provider Directory roles.
-
- Allergy & Immunology Physician
- Albany, NY
- NPI 1497921688
-
- Urgent Care Clinic/Center
- Albany, NY
- NPI 1386038925
-
- General Acute Care Hospital
- Albany, NY
- NPI 1376577247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1215515697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 NEW SCOTLAND AVENUE",
"address_2": "DEPT. OF PEDIATRICS",
"city": "ALBANY",
"state": "NY",
"postal_code": "12208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 NEW SCOTLAND AVENUE",
"address_2": "DEPT. OF PEDIATRICS",
"city": "ALBANY",
"state": "NY",
"postal_code": "12208",
"telephone_number": "518-262-5626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAZULA",
"first_name": "ABHILASH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-29",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "64449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.