Individual provider Active NPI

Bruce Gingold, MD

  • Colon & Rectal Surgery Physician
  • New York, NY
National Provider Identifier
1730169889
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
108900 Issued in NY
Practice address
515 Madison Ave
Suite 705
New York, NY 10022-5403
Phone
(212) 675-2997
Fax
(212) 627-8389
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 108900 NY Primary

Addresses

Primary practice location

515 Madison Ave
Suite 705
New York, NY 10022-5403

Mailing address

515 Madison Ave
Suite 705
New York, NY 10022-5403
Phone (212) 675-2997

Other identifiers 1

IdentifierTypeStateIssuer
00192796MedicaidNY

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
I20050810001275 NY Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 7416986393 Reassigns benefits to 1 organization

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: bgingold@manhattancolon.mdlogic.direct-ci.com

Organizations & group practices 1

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1730169889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "address_2": "SUITE 705",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "212-675-2997",
            "fax_number": "212-627-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "address_2": "SUITE 705",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "212-675-2997",
            "fax_number": "212-627-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINGOLD",
        "first_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "108900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00192796",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.