Individual provider Active NPI

Gavyn Alexander Gerbofsky, DO

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1477172104
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01087738A Issued in IN
Practice address
1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239
Phone
(317) 962-5975
NPI assigned
Apr 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 01087738A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239

Mailing address

1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239
Phone (317) 962-5975

Other practice location 1

720 Eskenazi Ave
Fifth Third Bank Building 3rd Fl
Indianapolis, IN 46202
Phone (317) 880-3900

Other practice location 2

1000 E Main St
Danville, IN 46122-1948
Phone (317) 718-2980 ext. 11036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220912002060 IN Practitioner - Emergency Medicine 9638591050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Marian University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical AssociatesGroup PAC ID 0840184164, 40 clinicians

Practice addresses (Care Compare)

1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone (317) 355-5041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
95.35
Improvement activities
40
Cost
78.59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

Organizations & group practices 1

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 4

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477172104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD # AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD # AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-5975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave",
            "address_2": "Fifth Third Bank Building 3rd Fl",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46202",
            "country_code": "US",
            "telephone_number": "317-880-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Main St",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IN",
            "postal_code": "461221948",
            "country_code": "US",
            "telephone_number": "317-718-2980 x11036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERBOFSKY",
        "first_name": "GAVYN",
        "middle_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01087738A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.