Organization Active NPI

Gramercy Park Gastroenterology PC

  • Specialist
  • New York, NY
National Provider Identifier
1407178759
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GRAMERCY PARK GASTROENTEROLOGY PC
Practice address
60 Gramercy Park N
New York, NY 10010-5423
Phone
(212) 845-9255
Fax
(347) 602-4674
NPI assigned
Feb 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Authorized official

Name
Dr. Lawrence John Ottaviano, MDNPI 1538112461
Title
Owner
Phone
(212) 845-9255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

60 Gramercy Park N
New York, NY 10010-5423

Mailing address

303 5TH Ave
Suite #1205
New York, NY 10016-6601
Phone (212) 845-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100623000399 NY Part B Supplier - Clinic/Group Practice 6709917537 Receives reassigned benefits from 6 practitioners
Practice locations: Elmhurst, NY; New York, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2265981Gramercy Park Gastroenterology, PC60 Gramercy Park North, Suite 1M, New York, NY 10010ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Locations

250 Park Ave S
New York, NY 10003
Phone (212) 979-3237

303 5th Ave
Rm 1205
New York, NY 10016

227 E 19th St
#2
New York, NY 10003

2 Bennett Ave
Fl 2
New York, NY 10033
Phone (212) 364-7090

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1407178759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 5TH AVE",
            "address_2": "SUITE #1205",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166601",
            "telephone_number": "212-845-9255",
            "fax_number": "347-602-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 GRAMERCY PARK N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105423",
            "telephone_number": "212-845-9255",
            "fax_number": "347-602-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAMERCY PARK GASTROENTEROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "OTTAVIANO",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-845-9255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "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 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.