Patrick Chapin Gardocki, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

50 057148 Issued in NY

Practice address

74 Delaware Ave
Delmar, NY 12054-1548

Phone

(518) 439-3299

NPI assigned

Feb 11, 2014

Last updated

Feb 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital Area Hudson Valley New York Dental PC

  dba 1st Advantage Dental - Delmar

  • General Practice Dentistry
  • Delmar, NY
  • NPI 1093463499
  NPD (past)

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1356765309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541548",
            "telephone_number": "518-439-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541548",
            "telephone_number": "518-439-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDOCKI",
        "first_name": "PATRICK",
        "middle_name": "CHAPIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "50 057148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Fruiterman
• Jacqueline A Gaffney, LCSW-R
• Susan Gardiner, M.D.
• Nancy Noble Gardner, LCSW
• Sheila Fulton Gardner, M.D.
• Jill C Genua, M.D.
• Ghulam Akbari Medicine PLLC
• Ghulam Akbari Medicine PLLC
• Ghulam Akbari Medicine PLLC
• Michael Gibbons, MS,OTR/L

• Dentist in Delmar, NY
• Providers in Delmar, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.

Verify at the official NPI Registry.