Individual provider Active NPI

Gagan Jagdish Gulati, MD

  • Pediatrics Physician
  • Flushing, NY
National Provider Identifier
1407808306
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
214934 Issued in NY
Practice address
4500 Parsons Boulevard
Flushing Hospital and Medical Center
Flushing, NY 11355
Phone
(718) 670-5000
Fax
(610) 617-6280
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 214934 NY
Pediatrics Physician 208000000X 214934 NY Primary

Addresses

Primary practice location

4500 Parsons Boulevard
Flushing Hospital and Medical Center
Flushing, NY 11355

Mailing address

PO Box 13700-1420
Flushing Hospital and Medical Center
Philadelphia, PA 19191-1420
Phone (800) 777-2455

Other identifiers 1

IdentifierTypeStateIssuer
02116741MedicaidNY

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
I20080823000028 NY Practitioner - Pediatric Medicine 6709988140 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214934NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital Medical Center CurrentSince Dec 1, 2006 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Dec 1, 2006 Accepting new patients
Walk-in Pediatric Care PLLC Pediatrics Current Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients
Flushing Emergency Practice Plan Emergency Medicine Past Accepting new patients

Locations

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1407808306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13700-1420",
            "address_2": "FLUSHING HOSPITAL AND MEDICAL CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191911420",
            "telephone_number": "800-777-2455",
            "fax_number": "610-617-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BOULEVARD",
            "address_2": "FLUSHING HOSPITAL AND MEDICAL CENTER",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-670-5000",
            "fax_number": "610-617-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULATI",
        "first_name": "GAGAN",
        "middle_name": "JAGDISH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-05-29",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "214934",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "214934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02116741",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.