Individual provider Active NPI

Gary Roxland, MD

  • Internal Medicine Physician
  • Bayside, NY
National Provider Identifier
1730266222
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0994621 Issued in NY
Practice address
15 05 Bell Boulevard
Bayside, NY 11360-1229
Phone
(718) 225-8011
Fax
(718) 225-0180
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0994621 NY Primary

Addresses

Primary practice location

15 05 Bell Boulevard
Bayside, NY 11360-1229

Mailing address

15 05 Bell Boulevard
Bayside, NY 11360-1229
Phone (718) 225-8011

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
I20100720000178 NY Practitioner - Internal Medicine 7012048507 Practice locations: Bayside, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0994621NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1730266222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 05 BELL BOULEVARD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601229",
            "telephone_number": "718-225-8011",
            "fax_number": "718-225-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 05 BELL BOULEVARD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601229",
            "telephone_number": "718-225-8011",
            "fax_number": "718-225-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROXLAND",
        "first_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "0994621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.