Active NPI
Gerald J Smallberg, MD
- Neurology Physician
- New York, NY
National Provider Identifier
1386758696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 123788
- Practice address
- 1010 Fifth Avenue
New York, NY 10028 - Phone
- (212) 535-5348
- Fax
- (212) 535-6406
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 123788 | NY | Primary |
Addresses
Primary practice location
1010 Fifth Avenue
New York, NY 10028
Mailing address
1010 Fifth Avenue
New York, NY 10028
Phone (212) 535-5348
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 1, 2016 through Jun 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386758696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 FIFTH AVENUE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10028",
"telephone_number": "212-535-5348",
"fax_number": "212-535-6406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 FIFTH AVENUE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10028",
"telephone_number": "212-535-5348",
"fax_number": "212-535-6406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALLBERG",
"first_name": "GERALD",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "123788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.