NPIMap

Individual provider Active NPI

Gary Andrew Dellacerra, D.O.

  • Body Imaging Physician
  • Philadelphia, PA
National Provider Identifier
1629411194
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
OS019610 Issued in PA
Practice address
132 S 10TH St FL 10
Philadelphia, PA 19107
Phone
(215) 955-6226
NPI assigned
Apr 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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 OS019610 PA Primary

Addresses

Primary practice location

132 S 10TH St FL 10
Philadelphia, PA 19107

Mailing address

101 E Olney Ave
Ste 400
Philadelphia, PA 19120-2470
Phone (215) 955-6226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190725002869 NY Practitioner - Diagnostic Radiology 9638425978 Reassigns benefits to 3 organizations
I20220912001494 CT Practitioner - Diagnostic Radiology 9638425978 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

219 Den Rd
Stamford, CT 06903-4306
Phone (516) 405-7000

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

9525 Queens Blvd
Rego Park, NY 11374-4510
Phone (718) 360-5522

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients
Einstein Practice Plan Inc Body Imaging CurrentSince Jan 2, 2019 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 2, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 15, 2022 Accepting new patients

Locations

945 Summer St
Stamford, CT 06905
Phone (203) 276-4309

111 E 210th St
Bronx, NY 10467

200 E Gun Hill Rd
Bronx, NY 10467
Phone (718) 798-5449

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

972 Brush Hollow Rd
Westbury, NY 11590

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5501 Old York Rd
Bldg Grd
Philadelphia, PA 19141
Phone (215) 456-6200

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

Networks

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

Interoperability endpoints

  • Direct secure messaging: gdellacerra68513@northwell.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1629411194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-955-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST FL 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLACERRA",
        "first_name": "GARY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PA",
            "license": "OS019610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.