Individual provider Active NPI

William Samuel Gaetano, MD

  • Family Medicine Physician
  • New Hartford, NY
National Provider Identifier
1447543673
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
276484 Issued in NY
Practice address
1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone
(315) 798-1400
Fax
(315) 798-1407
NPI assigned
May 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 276484 NY Primary

Addresses

Primary practice location

1729 Burrstone Rd
New Hartford, NY 13413-1001

Mailing address

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1400

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
I20140826000983 NY Practitioner - Family PracticePractitioner - Emergency Medicine 9739323940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Services of New York, P.C.Group PAC ID 8325939804, 128 clinicians

Practice addresses (Care Compare)

2209 Genesee St
Utica, NY 13501-5930
Phone (315) 798-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276484NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
MVHS Inc CurrentSince Jun 1, 2015 Accepting new patients
MVHS Inc Family Medicine CurrentSince Jun 1, 2015 Accepting new patients

Locations

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

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": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1447543673",
    "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": "315-798-1400",
            "fax_number": "315-798-1407"
        },
        {
            "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": "315-798-1400",
            "fax_number": "315-798-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETANO",
        "first_name": "WILLIAM",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-20",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "276484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.