Individual provider Active NPI

Michael Gaesser, M.D.

  • Internal Medicine Physician
  • Poughkeepsie, NY
National Provider Identifier
1568461713
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219612 Issued in NY
Practice address
1 Webster Ave Ste 301
Suite 301, 3Rd Floor
Poughkeepsie, NY 12601-1364
Phone
(845) 790-6100
Fax
(845) 345-9966
NPI assigned
Jul 19, 2005
Reactivated
Mar 24, 2006
Last updated
Apr 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219612 NY Primary

Addresses

Primary practice location

1 Webster Ave Ste 301
Suite 301, 3Rd Floor
Poughkeepsie, NY 12601-1364

Mailing address

243 North Rd
Suite 304
Poughkeepsie, NY 12601-1172
Phone (845) 471-9410

Other identifiers 4

IdentifierTypeStateIssuer
08S011OtherNYMEDICARE PTAN
02104281MedicaidNY
363284OtherNYMVP
446676OtherNYAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040309001328 NY Practitioner - Internal Medicine 2567350853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Webster Ave
Suite 307
Poughkeepsie, NY 12601-1365
Phone (845) 790-6100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of the Hudson Valley P.C. Internal Medicine CurrentSince Oct 6, 2014 Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Oct 6, 2014 Accepting new patients
Nuvance Health Medical Practice PC Internal Medicine Past Accepting new patients
Saint Francis Hospital / Medicine Past Accepting new patients
Crystal Run Healthcare Physicians LLP Past Accepting new patients

Locations

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

243 North Rd
Ste 103
Poughkeepsie, NY 12601
Phone (845) 454-0728

1 Webster Ave
Ste 307
Poughkeepsie, NY 12601
Phone (845) 471-1002

1 Webster Ave
Ste 301
Poughkeepsie, NY 12601
Phone (845) 483-5858

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mgaesser@premiermedicalhv.medentdirect.com

Organizations & group practices 5

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 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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1568461713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 NORTH RD",
            "address_2": "SUITE 304",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011172",
            "telephone_number": "845-471-9410",
            "fax_number": "845-451-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE STE 301",
            "address_2": "SUITE 301, 3RD FLOOR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011364",
            "telephone_number": "845-790-6100",
            "fax_number": "845-345-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAESSER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2015-04-23",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "08S011",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02104281",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "363284",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "446676",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.