Individual provider Active NPI

Maria B Gesualdo, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • New Hartford, NY
National Provider Identifier
1407840614
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
229084 Issued in NY
Practice address
1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone
(315) 798-1702
Fax
(315) 798-1726
NPI assigned
Sep 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 229084 NY Primary
Pulmonary Disease Physician 207RP1001X 229084 NY

Addresses

Primary practice location

1729 Burrstone Rd
New Hartford, NY 13413-1001

Mailing address

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1702

Other identifiers 1

IdentifierTypeStateIssuer
01899503MedicaidNY

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
I20040417000450 NY Practitioner - Pulmonary Disease 2466447529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
New York College of Osteo Medicine of New York Institute of Technology, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians
Slocum Dickson Medical Group PLLCGroup PAC ID 5799778510, 79 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6000

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229084NYMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Slocum Dickson Medical Group PLLC CurrentSince May 15, 2004 Accepting new patients
MVHS Inc CurrentSince May 1, 2024 Accepting new patients
MVHS Inc CurrentSince May 1, 2024 Accepting new patients

Locations

201 E State St
Herkimer, NY 13350
Phone (315) 574-0026

1729 Burrstone Rd
New Hartford, NY 13413
Phone (315) 798-1500

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1407840614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1702",
            "fax_number": "315-798-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1702",
            "fax_number": "315-798-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESUALDO",
        "first_name": "MARIA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "229084",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "229084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01899503",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.