Individual provider Active NPI

Tariq Gill, MD

  • Diagnostic Radiology Physician
  • Latham, NY
National Provider Identifier
1629069679
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
146501 Issued in NY
Practice address
711 Troy-Schenectady Road
Latham, NY 12110
Phone
(518) 782-3700
Fax
(518) 782-3799
NPI assigned
Oct 31, 2005
Last updated
Oct 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 146501 NY Primary

Addresses

Primary practice location

711 Troy-Schenectady Road
Latham, NY 12110

Mailing address

711 Troy-Schenectady Road
Suite 203
Latham, NY 12110
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
00864902MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040423000873 NY Practitioner - Diagnostic Radiology 4981690948 Reassigns benefits to 5 organizations
I20231129003455 FL Practitioner - Diagnostic Radiology 4981690948 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians
Albany Medical Center HospitalGroup PAC ID 8224018999, 45 clinicians

Practice addresses (Care Compare)

159 Jefferson HTS
Catskill, NY 12414-1237
Phone (518) 828-7601

1690 Renaissance Commons Blvd
Apt 1528
Boynton Beach, FL 33426-7214
Phone (518) 785-5881

1783 Route 9
Halfmoon, NY 12065-2465

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5149

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

801 S Olive Ave
Unit 1517
West Palm Beach, FL 33401-6181
Phone (518) 262-3277

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
146501NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Oct 21, 2018 Accepting new patients
Ellis Hospital CurrentSince May 28, 2019 Accepting new patients
Albany Medical College CurrentSince Oct 27, 2020 Accepting new patients
Albany Medical Center Hospital Diagnostic Radiology CurrentSince Sep 1, 2012 Accepting new patients
Community Care Physicians, PLLC Diagnostic Radiology CurrentSince Sep 24, 2012 Accepting new patients
Albany Medical College Diagnostic Radiology CurrentSince Oct 21, 2018 Accepting new patients
Community Care Physicians, PC Past Accepting new patients
Comprehensive MRI of New York, P.C. Past Accepting new patients
Stand-Up MRI of Bensonhurst, PC Diagnostic Radiology PastSince Jan 1, 1995 Accepting new patients
Comprehensive MRI of New York, P.C. Diagnostic Radiology Past Accepting new patients
Millennium Medical Imaging PC Diagnostic Radiology Past Accepting new patients
Stand-Up MRI of Staten Island, PC Diagnostic Radiology PastSince Jan 1, 1995 Accepting new patients
Lucia's Pharmacy Inc. PastSince Nov 1, 2019 Accepting new patients

Locations

1365 Washington Ave
Ste 103
Albany, NY 12206
Phone (518) 465-6501

1367 Washington Ave
Albany, NY 12206
Phone (518) 438-7926

43 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5149

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#113
Albany, NY 12208

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

Interoperability endpoints

  • Direct secure messaging: tgill24861@albanymed.direct-ci.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 9

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1629069679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY-SCHENECTADY ROAD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY-SCHENECTADY ROAD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "TARIQ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "146501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00864902",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.