Active NPI
Gary S Meredith, M.D.
- Rheumatology Physician
- Jericho, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 56383
- Practice address
- 425 N Broadway Unit 698
Jericho, NY 11753-5034 - Phone
- (516) 650-4733
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 151225 | NY | |
| Rheumatology Physician | 207RR0500X | 1258 | WI | |
| Rheumatology Physician | 207RR0500X | 56383 | CT | Primary |
Addresses
Primary practice location
425 N Broadway Unit 698
Jericho, NY 11753-5034
Mailing address
425 N Broadway Unit 698
Jericho, NY 11753-5034
Phone (516) 650-4733
Other practice location 1
1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, AZ, WI, WV, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
123 Franklin Corner Rd
Suite 106
Lawrence Township, NJ 08648-2526
Phone (609) 896-2505
1739 E Beverly Ave
Suite 209
Kingman, AZ 86409-3593
Phone (928) 627-8520
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56383 | CT | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Medical Center, Inc | Current | Accepting new patients | |
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Kingman Healthcare, Inc | Current | Accepting new patients | |
| Kingman Healthcare, Inc | Family Medicine | Current | Accepting new patients |
| Kingman Healthcare, Inc | Current | Accepting new patients | |
| Dean Health Systems, Inc. | Current | Accepting new patients | |
| Dean Health Systems, Inc | Family Medicine | Current | Accepting new patients |
| Gundersen Lutheran Medical Center, Inc. | Current | Accepting new patients | |
| Kingman Healthcare, Inc | Family Medicine | Past | Accepting new patients |
Locations
3801 Santa Rosa Dr
Ste 301
Kingman, AZ 86401
Phone (928) 681-8730
1739 E Beverly Ave
Ste 209
Kingman, AZ 86409
Phone (928) 627-8520
3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
Interoperability endpoints
- meredith.gary@st.direct.azkrmc.md
Organizations & group practices 10
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.
-
dba Kingman Regional Medical Center
- General Acute Care Hospital
- Kingman, AZ
- NPI 1265423917
Family Medicine
-
- Family Medicine Physician
- Cherry Hill, NJ
- NPI 1447260435
-
dba SSM Health Dean Medical Group
- Allergy & Immunology Physician
- Madison, WI
- NPI 1053358846
Family Medicine
-
dba Emplify Health Hamilton Clinic
- Clinic/Center
- La Crosse, WI
- NPI 1225873458
-
dba SSM Health Davis Duehr Dean Eye Care - Portage
- Durable Medical Equipment & Medical Supplies
- Portage, WI
- NPI 1427085679
-
dba Emplify Health Onalaska Behavioral Health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
-
dba Emplify Health La Crosse Hospital DME
- Durable Medical Equipment & Medical Supplies
- La Crosse, WI
- NPI 1447478607
-
dba KRMC Community Pharmacy
- Community/Retail Pharmacy
- Kingman, AZ
- NPI 1992286298
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kingman Regional Medical Center
- General Acute Care Hospital
- Kingman, AZ
- NPI 1265423917
-
dba Penn Medicine Princeton Medical Center
- General Acute Care Hospital
- Plainsboro, NJ
- NPI 1689714255
-
dba Hospital of the University of Pennsylvania
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1851370910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1659383503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 N BROADWAY UNIT 698",
"city": "JERICHO",
"state": "NY",
"postal_code": "117535034",
"telephone_number": "516-650-4733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 N BROADWAY UNIT 698",
"city": "JERICHO",
"state": "NY",
"postal_code": "117535034",
"telephone_number": "516-650-4733"
}
],
"practiceLocations": [
{
"address_1": "1836 South Ave",
"address_purpose": "LOCATION",
"city": "LA Crosse",
"state": "WI",
"postal_code": "546015429",
"country_code": "US",
"telephone_number": "608-782-7300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEREDITH",
"first_name": "GARY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2021-07-28",
"certification_date": "2021-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NY",
"license": "151225",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "WI",
"license": "1258",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "CT",
"license": "56383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jericho, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.