Individual provider Active NPI

Gajanan W Laud, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1255484440
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
128638 Issued in NY
Practice address
6647 Grand Ave
Maspeth
New York, NY 11378
Phone
(718) 424-0700
Fax
(718) 424-9708
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 128638 NY Primary

Addresses

Primary practice location

6647 Grand Ave
Maspeth
New York, NY 11378

Mailing address

6647 Grand Ave
Maspeth
New York, NY 11378
Phone (718) 424-0700

Other identifiers 1

IdentifierTypeStateIssuer
00302130MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091111000518 NY Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 7012055080

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: gajanan.laud@gajananwlaud.ehi.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1255484440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6647 GRAND AVE",
            "address_2": "MASPETH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11378",
            "telephone_number": "718-424-0700",
            "fax_number": "718-424-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6647 GRAND AVE",
            "address_2": "MASPETH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11378",
            "telephone_number": "718-424-0700",
            "fax_number": "718-424-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUD",
        "first_name": "GAJANAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-12-02",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "128638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00302130",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.