Organization Active NPI

Gamaliel Immanuel,Physician PC

  • Gastroenterology Physician
  • Hempstead, NY
National Provider Identifier
1538469713
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
142841 Issued in NY
Legal business name
GAMALIEL IMMANUEL,PHYSICIAN PC
Practice address
230 Hilton Ave
Suite 214
Hempstead, NY 11550
Phone
(516) 565-5556
Fax
(516) 483-0396
NPI assigned
Oct 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Authorized official

Name
Gamaliel Immanuel, M.DNPI 1598855231
Title
Physician P.C.
Phone
(516) 565-5556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 142841 NY Primary

Addresses

Primary practice location

230 Hilton Ave
Suite 214
Hempstead, NY 11550

Mailing address

230 Hilton Ave
Suite 214
Hempstead, NY 11550
Phone (516) 565-5556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110331000012 NY Part B Supplier - Clinic/Group Practice 3274716162 Receives reassigned benefits from 1 practitioner
Practice locations: Hempstead, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0938480Gamaliel Immanuel Physician PC230 Hilton Avenue, Suite 214, Hempstead, NY 11550ComplianceNov 27, 2027

National Provider Directory

National Provider Directory

Locations

230 Hilton Ave
Hempstead, NY 11550
Phone (516) 254-3390

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1538469713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HILTON AVE",
            "address_2": "SUITE 214",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "11550",
            "telephone_number": "516-565-5556",
            "fax_number": "516-483-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HILTON AVE",
            "address_2": "SUITE 214",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "11550",
            "telephone_number": "516-565-5556",
            "fax_number": "516-483-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMALIEL IMMANUEL,PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "IMMANUEL",
        "authorized_official_first_name": "GAMALIEL",
        "authorized_official_title_or_position": "PHYSICIAN P.C.",
        "authorized_official_telephone_number": "516-565-5556",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "142841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.