NPIMap

Individual provider Active NPI

Gerard V Siciliano, M.D.

  • Gastroenterology Physician
  • Louisville, KY
National Provider Identifier
1558322917
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
32151 Issued in KY
Practice address
3999 Dutchmans LN
Suite 7B
Louisville, KY 40207-4729
Phone
(502) 896-4711
Fax
(502) 896-4791
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 32151 KY
Specialist 174400000X 32151 KY
Gastroenterology Physician 207RG0100X 32151 KY Primary

Addresses

Primary practice location

3999 Dutchmans LN
Suite 7B
Louisville, KY 40207-4729

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 4

IdentifierTypeStateIssuer
201080170MedicaidIN
000000049918OtherKYANTHEM PIN #
64321516MedicaidKY
50034545OtherKYPASSPORT- NORTON SURGICAL SPECIALISTS

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/
Direct Messaging Address gsiciliano5276@direct.nortonhealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20101005000805 KY Practitioner - Gastroenterology 9931391232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Albert Einstein College of Medicine of Yeshiva University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

3991 Dutchmans LN
Suite 310
Louisville, KY 40207-4716
Phone (502) 899-6782

3999 Dutchmans LN
Suite 7B
Louisville, KY 40207-4742
Phone (502) 896-4711

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8125

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy143
Upper gastrointestinal (GI) endoscopy for acid reflux195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32151KYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward C Adler and Associates Specialist Current Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2011 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2011 Accepting new patients

Locations

1373 E State Road 62
Ste 1C
Madison, IN 47250
Phone (812) 801-0832

210 E Gray St
Ste 602
Louisville, KY 40202
Phone (502) 582-6900

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

3999 Dutchmans Ln
Ste 7B
Louisville, KY 40207
Phone (502) 896-4711

Interoperability endpoints

  • Direct secure messaging: gsiciliano5276@direct.nortonhealthcare.org

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1558322917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LN",
            "address_2": "SUITE 7B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074729",
            "telephone_number": "502-896-4711",
            "fax_number": "502-896-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIANO",
        "first_name": "GERARD",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "32151",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "32151",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "32151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201080170",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN #",
            "identifier": "000000049918",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64321516",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT- NORTON SURGICAL SPECIALISTS",
            "identifier": "50034545",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "3999 Dutchmans Ln",
            "address_2": "SUITE 7B",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gsiciliano5276@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3999 Dutchmans Ln",
            "address_2": "SUITE 7B",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.