Individual provider Active NPI

Joseph Gartner, MD

  • Neurodevelopmental Disabilities Physician
  • East Setauket, NY
National Provider Identifier
1376584102
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X
License
160396 Issued in NY
Practice address
37 Research Way
East Setauket, NY 11733-3465
Phone
(631) 553-3499
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurodevelopmental Disabilities Physician 2084P0005X 160396 NY Primary

Addresses

Primary practice location

37 Research Way
East Setauket, NY 11733-3465

Mailing address

2 Constance Court
E Setauket, NY 11733
Phone (631) 553-3499

Other identifiers 3

IdentifierTypeStateIssuer
01293452MedicaidNY
0293452MedicaidNY
5310574OtherNYAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1376584102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CONSTANCE COURT",
            "city": "E SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-553-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 RESEARCH WAY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333465",
            "telephone_number": "631-553-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "160396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01293452",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0293452",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5310574",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.