NPIMap

Individual provider Active NPI

Gary Czulada, DO

  • Family Medicine Physician
  • Dover, PA
National Provider Identifier
1477578573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS005842L Issued in PA
Practice address
3740 Carlisle Rd
Dover, PA 17315-4416
Phone
(717) 292-3168
Fax
(717) 292-3479
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 OS005842L PA Primary

Addresses

Primary practice location

3740 Carlisle Rd
Dover, PA 17315-4416

Mailing address

3740 Carlisle Rd
Dover, PA 17315-4416
Phone (717) 292-3168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040505001303 PA Practitioner - Family Practice 9133117252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Davenshire Medical Center PartnershipGroup PAC ID 2062400187, 4 clinicians

Practice addresses (Care Compare)

3740 Carlisle Rd
Dover, PA 17315-4416
Phone (717) 292-3168

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS005842LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Davenshire Medical Center Partnership Family Medicine CurrentSince Jan 1, 2002 Accepting new patients

Locations

3740 Carlisle Rd
Dover, PA 17315
Phone (717) 292-3168

Interoperability endpoints

  • Direct secure messaging: gczulada@davenshiremc.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477578573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 CARLISLE RD",
            "city": "DOVER",
            "state": "PA",
            "postal_code": "173154416",
            "telephone_number": "717-292-3168",
            "fax_number": "717-292-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 CARLISLE RD",
            "city": "DOVER",
            "state": "PA",
            "postal_code": "173154416",
            "telephone_number": "717-292-3168",
            "fax_number": "717-292-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZULADA",
        "first_name": "GARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS005842L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, PA

Sources for this page

Verify at the official NPI Registry.