Individual provider Active NPI

Douglas Gladstone, M.D.

  • Medical Oncology Physician
  • Baltimore, MD
National Provider Identifier
1386660207
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
D50264 Issued in MD
Practice address
1650 Orleans St
CRB I , Suite 287 - Oncology
Baltimore, MD 21287-0013
Phone
(443) 287-6471
Fax
(410) 955-8893
NPI assigned
Jul 14, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 193432 NY
Medical Oncology Physician 207RX0202X D50264 MD Primary

Addresses

Primary practice location

1650 Orleans St
CRB I , Suite 287 - Oncology
Baltimore, MD 21287-0013

Mailing address

PO Box 64474
Baltimore, MD 21264-4474

Other identifiers 4

IdentifierTypeStateIssuer
01581671MedicaidNY
264401100MedicaidMD
0034K1OtherNYEMPIRE BC.BS
7844481OtherNYAETNA

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
I20040331001672 NY Practitioner - Medical Oncology 7315939253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
New York University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

210 E 64TH St
New York, NY 10065-7471
Phone (212) 434-4460

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-4449

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 734-8900

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-8005

440 E Main St
Bay Shore, NY 11706-8501

450 Lakeville Rd
New Hyde Park, NY 11042-1118
Phone (516) 734-8900

9525 Queens Boluevard
2ND Floor Suite B
Rego Park, NY 11374-4511
Phone (718) 925-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.07 of 100Reported as group
Quality
57.91
Promoting interoperability
77
Improvement activities
40
Cost
80.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D50264MDMDMedical Oncology Physician
193432NYMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Health System Medical Faculty Group Practice Inc CurrentSince Jul 18, 2022 Accepting new patients
North Shore University Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
I. Brodsky Associates Past Accepting new patients

Locations

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

27005 76th Ave
North New Hyde Pk, NY 11040

9525 Queens Blvd
Ste B
Rego Park, NY 11374
Phone (718) 925-6200

Networks

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

Interoperability endpoints

  • Direct secure messaging: dgladstone218438@northwell.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1386660207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64474",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 ORLEANS ST",
            "address_2": "CRB I , SUITE 287 - ONCOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870013",
            "telephone_number": "443-287-6471",
            "fax_number": "410-955-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSTONE",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "193432",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MD",
            "license": "D50264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01581671",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264401100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "0034K1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7844481",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.