Individual provider Active NPI

Anastasia Gentles, DO

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1780075879
Registry record updated Jan 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
288611 Issued in NY
Practice address
10 Rockefeller PLZ
New York, NY 10020-1903
Phone
(212) 332-3700
NPI assigned
Feb 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 288611 NY Primary

Addresses

Primary practice location

10 Rockefeller PLZ
New York, NY 10020-1903

Mailing address

10 Rockefeller PLZ
New York, NY 10020-1903

Other practice location 1

89-06 135th street
suite 3D
Jamaica, NY 11418
Phone (718) 206-6919

Other practice location 2

38A Classic St
Sherburne, NY 13460-9723
Phone (607) 674-4495

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Family Medicine Current Accepting new patients
Executive Health Medical Group of New Jersey, PC Past Accepting new patients
Form Health Associates Ma, P.C. Family Medicine Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: anastasiagentles@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547251200000",
    "number": "1780075879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ROCKEFELLER PLZ",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ROCKEFELLER PLZ",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201903",
            "telephone_number": "212-332-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "89-06 135th street",
            "address_2": "suite 3D",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "11418",
            "country_code": "US",
            "telephone_number": "718-206-6919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38A Classic St",
            "address_purpose": "LOCATION",
            "city": "Sherburne",
            "state": "NY",
            "postal_code": "134609723",
            "country_code": "US",
            "telephone_number": "607-674-4495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTLES",
        "first_name": "ANASTASIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2019-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "288611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2019; 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.