Individual provider Active NPI

Samuel H Gartner, M.D.

  • Child & Adolescent Psychiatry Physician
  • Dix Hills, NY
National Provider Identifier
1760800700
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
287667 Issued in NY
Practice address
197 Half Hollow Rd
Dix Hills, NY 11746-5859
Phone
(631) 370-1701
Fax
(631) 370-1714
NPI assigned
Apr 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 287667 NY
Child & Adolescent Psychiatry Physician 2084P0804X 287667 NY Primary

Addresses

Primary practice location

197 Half Hollow Rd
Dix Hills, NY 11746-5859

Mailing address

197 Half Hollow Rd
Dix Hills, NY 11746-5859
Phone (631) 370-1701

Other practice location 1

101 Nicolls Rd
Stony Brook, NY 11794-1150
Phone (631) 632-2428

Other practice location 2

445 Broadhollow Rd Ste 105
Melville, NY 11747-3601
Phone (516) 834-6877

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
I20180810000624 NY Practitioner - Psychiatry 6103174974 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287667NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2018 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Psychiatry CurrentSince Jul 1, 2019 Accepting new patients
Nys Office of Mental Health Past Accepting new patients

Locations

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

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

79 Middleville Rd
Northport, NY 11768
Phone (631) 266-6057

300 Community Dr
Plandome, NY 11030

169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

Networks

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

Interoperability endpoints

  • Direct secure messaging: samuel.gartner@direct.stonybrookmedicine.edu

Organizations & group practices 4

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": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1760800700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 HALF HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465859",
            "telephone_number": "631-370-1701",
            "fax_number": "516-273-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 HALF HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465859",
            "telephone_number": "631-370-1701",
            "fax_number": "631-370-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Nicolls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117941150",
            "country_code": "US",
            "telephone_number": "631-632-2428",
            "fax_number": "631-444-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 Broadhollow Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117473601",
            "country_code": "US",
            "telephone_number": "516-834-6877",
            "fax_number": "516-273-7133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "SAMUEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-06",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "287667",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "287667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.