Individual provider Active NPI

Bora Gumustop, M.D.

  • Gastroenterology Physician
  • Albany, NY
National Provider Identifier
1386673424
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
220804 Issued in NY
Practice address
1375 Washington Ave
Suite 101
Albany, NY 12206-1056
Phone
(518) 438-4483
Fax
(518) 482-4201
NPI assigned
Jul 1, 2006
Last updated
Jul 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 220804 NY Primary

Addresses

Primary practice location

1375 Washington Ave
Suite 101
Albany, NY 12206-1056

Mailing address

1375 Washington Ave
Suite 101
Albany, NY 12206-1056
Phone (518) 438-4483

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
I20100824000407 NY Practitioner - Gastroenterology 2062584089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastrointestinal Care of Long Island PLLCGroup PAC ID 7517042211, 175 clinicians

Practice addresses (Care Compare)

1785 Route 9
Suite 101
Halfmoon, NY 12065-2449
Phone (518) 533-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy105
Upper gastrointestinal (GI) endoscopy for acid reflux169

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Care of Long Island PLLC Gastroenterology CurrentSince Nov 1, 2024 Accepting new patients
Albany Medical College CurrentSince Sep 14, 2019 Accepting new patients
Albany Medical College Gastroenterology CurrentSince Sep 14, 2019 Accepting new patients
Albany Medical College CurrentSince Sep 15, 2019 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

1375 Washington Ave
Ste 101
Albany, NY 12206
Phone (518) 438-4483

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1785 Route 9
Ste 101
Halfmoon, NY 12065
Phone (518) 533-1269

713 Troy Schenectady Rd
Ste 224
Latham, NY 12110
Phone (518) 785-3614

187 Veterans Blvd
Massapequa, NY 11758
Phone (516) 795-5523

187 Veterans Blvd
#13202
Massapequa, NY 11758
Phone (516) 795-5523

Networks

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

Interoperability endpoints

  • Direct secure messaging: bora.gumustop.1@24721.direct.athenahealth.com

Organizations & group practices 5

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 2

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1386673424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 WASHINGTON AVE",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061056",
            "telephone_number": "518-438-4483",
            "fax_number": "518-482-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 WASHINGTON AVE",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061056",
            "telephone_number": "518-438-4483",
            "fax_number": "518-482-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMUSTOP",
        "first_name": "BORA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "220804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.