NPIMap

Individual provider Active NPI

Edward Gillis, D.O.

  • Diagnostic Radiology Physician
  • Durham, NC
National Provider Identifier
1508212861
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2021-01702 Issued in NC
Practice address
2301 Erwin Rd Duke Hospital North
Durham, NC 27710-3931
Phone
(919) 684-7272
Fax
(919) 684-7129
NPI assigned
May 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 70875 CT
Diagnostic Radiology Physician 2085R0202X 2021-01702 NC Primary

Addresses

Primary practice location

2301 Erwin Rd Duke Hospital North
Durham, NC 27710-3931

Mailing address

2301 Erwin Rd Box 3808 Room 1512D1 Duke Hospital North
Durham, NC 27710-0001
Phone (919) 684-7272

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-3931
Phone (860) 679-3312

Other practice location 2

263 Farmington Ave
Farmington, CT 06030-3931
Phone (860) 679-3312

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
I20220723000059 CT Practitioner - Diagnostic Radiology 5698047843 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Imaging Specialists LLCGroup PAC ID 9234676164, 47 clinicians
Specialty Imaging Associates LLCGroup PAC ID 6406897354, 10 clinicians
Danbury Radiological Associates, PCGroup PAC ID 2264408533, 35 clinicians
Premier Imaging LLCGroup PAC ID 8820403637, 42 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (203) 426-3002

2 Riverview Dr
Suite 104
Danbury, CT 06810-6268
Phone (203) 426-3002

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7532

34 Maple St
Norwalk, CT 06850-3815
Phone (203) 748-0834

84 N Main St
Branford, CT 06405-3061
Phone (203) 483-2509

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

Merit-based Incentive Payment System (MIPS)

Final score
87.81 of 100Reported as group
Quality
79.31
Promoting interoperability
100
Improvement activities
40
Cost
80.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Danbury Radiological Associates, PC Diagnostic Radiology CurrentSince Jul 25, 2022 Accepting new patients
Connecticut Orthopaedic Specialists, PC CurrentSince Jun 17, 2024 Accepting new patients
Western Connecticut Health Network Affiliates, Inc. CurrentSince Jul 25, 2022 Accepting new patients
Mandell & Blau, MD'S PC Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Connecticut Orthopaedic Specialists, PC CurrentSince Jun 17, 2024 Accepting new patients
Premier Imaging LLC Diagnostic Radiology CurrentSince Jul 25, 2022 Accepting new patients
Mandell & Blau, MD'S PC Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Advanced Imaging Specialists, LLC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Specialty Imaging Associates, LLC Diagnostic Radiology CurrentSince Jul 25, 2022 Accepting new patients
Western Connecticut Health Network Affiliates, Inc. CurrentSince Jul 25, 2022 Accepting new patients

Locations

84 N Main St
Branford, CT 06405
Phone (203) 483-2015

2 Riverview Dr
Ste 104
Danbury, CT 06810
Phone (203) 739-7532

60 Newtown Rd
#45
Danbury, CT 06810

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

12 Bokum Rd
Essex, CT 06426
Phone (860) 767-9035

124 Hebron Ave
Ste 1B
Glastonbury, CT 06033
Phone (860) 633-8806

2416 Whitney Ave
Hamden, CT 06518
Phone (203) 248-4331

2408 Whitney Ave
Hamden, CT 06518
Phone (203) 407-3500

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

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

491 Buckland Rd
Ste 3A
South Windsor, CT 06074
Phone (860) 633-8806

Organizations & group practices 10

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1508212861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD BOX 3808 ROOM 1512D1 DUKE HOSPITAL NORTH",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-684-7272",
            "fax_number": "919-684-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD DUKE HOSPITAL NORTH",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277103931",
            "telephone_number": "919-684-7272",
            "fax_number": "919-684-7129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060303931",
            "country_code": "US",
            "telephone_number": "860-679-3312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060303931",
            "country_code": "US",
            "telephone_number": "860-679-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "70875",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2021-01702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.