Individual provider Active NPI

Gerda L. Van de Vegte, M.D.

  • Body Imaging Physician
  • Stony Brook, NY
National Provider Identifier
1629010004
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
163824 Issued in NY
Practice address
University Hospital, L4
Stony Brook, NY 11794-0001
Phone
(631) 444-6919
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 163824 NY Primary

Addresses

Primary practice location

University Hospital, L4
Stony Brook, NY 11794-0001

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-6919

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
I20100428000037 NY Practitioner - Diagnostic Radiology 8820125610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Rochester School of Medicine and Dentistry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zwanger and Pesiri Radiology Group LLPGroup PAC ID 5092700799, 93 clinicians

Practice addresses (Care Compare)

150 Sunrise Hwy
Suite E
Lindenhurst, NY 11757-2598
Phone (631) 225-7200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Radiology, University Faculty Practice Corporation CurrentSince Jan 7, 1982 Accepting new patients
Zwanger & Pesiri Radiology Group, LLP CurrentSince Apr 16, 2017 Accepting new patients

Locations

160 Brentwood Rd
Bay Shore, NY 11706
Phone (631) 665-7240

1018 Suffolk Ave
Brentwood, NY 11717

763 Larkfield Rd
Commack, NY 11725
Phone (631) 462-0118

347 Middle Country Rd
Coram, NY 11727
Phone (631) 992-6403

2087 Deer Park Ave
Deer Park, NY 11729
Phone (631) 992-6401

285 Sills Rd
East Patchogue, NY 11772
Phone (631) 447-8300

220 N Belle Mead Rd
East Setauket, NY 11733
Phone (516) 681-8400

99 Smithtown Byp
Hauppauge, NY 11788
Phone (631) 930-3480

326 Walt Whitman Rd
Huntington Station, NY 11746
Phone (631) 673-1001

23135 Merrick Blvd
Laurelton, NY 11413
Phone (718) 481-8693

625 Rockaway Tpke
Lawrence, NY 11559
Phone (516) 288-3076

150 Sunrise Hwy
Ste 201
Lindenhurst, NY 11757

150 Sunrise Hwy
Ste E
Lindenhurst, NY 11757

126 Hicksville Rd
Massapequa, NY 11758
Phone (516) 798-3614

1729 N Ocean Ave
Medford, NY 11763
Phone (631) 289-4800

680 Old Country Rd
Plainview, NY 11803
Phone (516) 681-8400

4 Medical Dr
Port Jefferson Station, NY 11776
Phone (631) 428-1600

5650 Sunrise Hwy
Sayville, NY 11782

803 Montauk Hwy
Unit F
Shirley, NY 11967

987 W Jericho Tpke
Smithtown, NY 11787
Phone (516) 864-9100

80 Maple Ave
Smithtown, NY 11787
Phone (516) 265-5777

2500 Route 347
Stony Brook, NY 11790
Phone (631) 689-7700

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

6144 Route 25A
Ste 1
Wading River, NY 11792

759 Montauk Hwy
West Islip, NY 11795
Phone (516) 669-7103

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1629010004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY HOSPITAL, L4",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE VEGTE",
        "first_name": "GERDA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "163824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.