Individual provider Active NPI

Gaetano Pannella, M.D.

  • Cardiovascular Disease Physician
  • Woodbury, NY
National Provider Identifier
1306006176
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
252290 Issued in NY
Practice address
43 Crossways Park Dr W
Woodbury, NY 11797-2002
Phone
(516) 938-3000
NPI assigned
Jun 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 252290 NY Primary

Addresses

Primary practice location

43 Crossways Park Dr W
Woodbury, NY 11797-2002

Mailing address

43 Crossways Park Dr W
Woodbury, NY 11797-2002
Phone (516) 938-3000

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
I20120713000443 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0547425712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
State University of New York Downstate Medical Center, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 496-2752

221 Jericho Turnpike
Syosset, NY 11791-4515
Phone (516) 496-6500

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

43 Crossways Park Dr W
Woodbury, NY 11797-2002
Phone (516) 294-9380

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 719-3000

Hospital & facility affiliations

  • Plainview Hospital Hospital, Plainview, NY, CCN 330331
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Cardiovascular Disease CurrentSince Jun 30, 2012 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1001 Franklin Ave
Rm 106
Garden City, NY 11530
Phone (516) 240-8700

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

972 Brush Hollow Rd
Westbury, NY 11590

43 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 938-3000

Networks

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

Interoperability endpoints

  • Direct secure messaging: gaetanopannella@nslijmedgr.allscriptsdirect.net

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1306006176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CROSSWAYS PARK DR W",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972002",
            "telephone_number": "516-938-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 CROSSWAYS PARK DR W",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972002",
            "telephone_number": "516-938-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNELLA",
        "first_name": "GAETANO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-14",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "252290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.