NPIMap

Individual provider Active NPI

Gabriel Vincent Gambardella, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Bloomfield, CT
National Provider Identifier
1447577309
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0000895 Issued in CT
Practice address
1 Northwestern Drive
Suite 301
Bloomfield, CT 06002-3400
Phone
(860) 243-2951
Fax
(860) 243-5790
NPI assigned
Apr 30, 2010
Last updated
Jul 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0000895 CT Primary
Podiatrist 213E00000X 0000895 CT

Addresses

Primary practice location

1 Northwestern Drive
Suite 301
Bloomfield, CT 06002-3400

Mailing address

1 Northwestern Drive
Suite 301
Bloomfield, CT 06002-3400
Phone (860) 243-2951

Other identifiers 1

IdentifierTypeStateIssuer
1447577309MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130610000231 CT Practitioner - Podiatry 3678712379 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomfield Foot Specialists,LLCGroup PAC ID 5496645657, 3 clinicians
McLean FundGroup PAC ID 0648247403, 105 clinicians

Practice addresses (Care Compare)

705 Bloomfield Ave
Suite 201
Bloomfield, CT 06002-2480
Phone (860) 243-2951

75 Great Pond Rd
Simsbury, CT 06070-1980

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue98
Removal of skin lesions1-10
Removal of nail tissue363
Removal or shaving of skin growth147
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000895CTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jan 22, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jan 22, 2022 Accepting new patients
Bloomfield Foot Specialists,LLC Podiatrist CurrentSince Jul 1, 2014 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince May 14, 2014 Accepting new patients
Bloomfield Foot Specialists,LLC PastSince Jul 1, 2014 Accepting new patients

Locations

1 Northwestern Dr
Ste 301
Bloomfield, CT 06002
Phone (860) 243-2951

705 Bloomfield Ave
Ste 201
Bloomfield, CT 06002
Phone (860) 243-2951

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1447577309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORTHWESTERN DRIVE",
            "address_2": "SUITE 301",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023400",
            "telephone_number": "860-243-2951",
            "fax_number": "860-243-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NORTHWESTERN DRIVE",
            "address_2": "SUITE 301",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023400",
            "telephone_number": "860-243-2951",
            "fax_number": "860-243-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBARDELLA",
        "first_name": "GABRIEL",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-30",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "0000895",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "0000895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447577309",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.