Individual provider Active NPI

Victor D Gaines, MD

  • Diagnostic Radiology Physician
  • Poughkeepsie, NY
National Provider Identifier
1649279340
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
154174 Issued in NY
Practice address
1 Columbia St
VBMC Columbia St
Poughkeepsie, NY 12601-3923
Phone
(845) 454-4700
Fax
(845) 454-4982
NPI assigned
Jul 15, 2005
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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 154174 NY Primary

Addresses

Primary practice location

1 Columbia St
VBMC Columbia St
Poughkeepsie, NY 12601-3923

Mailing address

2678 South Rd Ste 202
Poughkeepsie, NY 12601-5254
Phone (845) 790-5700

Other identifiers 1

IdentifierTypeStateIssuer
00772261MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1649279340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2678 SOUTH RD STE 202",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015254",
            "telephone_number": "845-790-5700",
            "fax_number": "845-790-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA ST",
            "address_2": "VBMC COLUMBIA ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013923",
            "telephone_number": "845-454-4700",
            "fax_number": "845-454-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "VICTOR",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "154174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00772261",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.