Individual provider Active NPI

Kanwar Iqbal Singh Gill, MD

  • Interventional Cardiology Physician
  • Smithtown, NY
National Provider Identifier
1790943694
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
262723 Issued in NY
Practice address
300 E Main St Ste 6
Smithtown, NY 11787-2900
Phone
(631) 994-1200
Fax
(631) 994-1212
NPI assigned
May 28, 2008
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 262723 NY
Cardiovascular Disease Physician 207RC0000X 262723 NY
Interventional Cardiology Physician 207RI0011X 262723 NY Primary
Interventional Cardiology Physician 207RI0011X 0101263665 VA

Addresses

Primary practice location

300 E Main St Ste 6
Smithtown, NY 11787-2900

Mailing address

169 Commack Rd Ste 246
Commack, NY 11725-3442

Other practice location 1

169 Commack Rd Ste 246
Commack, NY 11725-3442
Phone (631) 352-0851

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
I20110915000687 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0941471395 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Marc Allen Medical PCGroup PAC ID 9133185770, 6 clinicians
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians
Arnot Medical Services PLLCGroup PAC ID 0840450748, 91 clinicians

Practice addresses (Care Compare)

1045 W Jericho Tpke
Smithtown, NY 11787-3205
Phone (631) 543-8844

600 Roe Ave
Elmira, NY 14905-1629
Phone 60773741004118

602 Ivy St
FL 1
Elmira, NY 14905-1646
Phone (607) 737-4577

7571 State Route 54
Bath, NY 14810-9504
Phone (607) 776-8500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting45
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262723NYMDInternal Medicine Physician
0101263665VAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Marc Allen Medical PC Internal Medicine CurrentSince May 1, 2024 Accepting new patients
Arnot Ogden Medical Center CurrentSince Dec 5, 2019 Accepting new patients
Ira Davenport Memorial Hospital, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Ira Davenport Memorial Hospital, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Arnot Medical Services PLLC Internal Medicine CurrentSince Sep 22, 2018 Accepting new patients
New York City Healthcare Medical Services LLC CurrentSince Jul 7, 2026 Accepting new patients
New York Professional Medical Services LLC CurrentSince Jul 1, 2018 Accepting new patients
Arnot Ogden Medical Center CurrentSince Dec 5, 2019 Accepting new patients
Ira Davenport Memorial Hospital, Inc. Current Accepting new patients
Vascular Anesthesia Associates PLLC Interventional Cardiology PastSince Jul 1, 2018 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500

2157 White Plains Rd
Ste B
Bronx, NY 10462

2444 86th St
Brooklyn, NY 11214
Phone (718) 709-5329

2444 86th St
#102A
Brooklyn, NY 11214
Phone (347) 230-8174

2511 Ocean Ave
Ste 102
Brooklyn, NY 11229
Phone (718) 504-6044

924 Flatbush Ave
Brooklyn, NY 11226
Phone (718) 709-5327

571 Saint Josephs Blvd
Ste 304
Elmira, NY 14901
Phone (607) 271-2050

600 Fitch St
Ste 202
Elmira, NY 14905
Phone (607) 271-3780

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161

602 Ivy St
Fl 1
Elmira, NY 14905
Phone (607) 737-4577

11602 Queens Blvd
Forest Hills, NY 11375
Phone (646) 292-3240

11602 Queens Blvd
Ste A
Forest Hills, NY 11375

16203 Jamaica Ave
Ste 200
Jamaica, NY 11432
Phone (347) 429-7699

16203 Jamaica Ave
Unit 200A
Jamaica, NY 11432
Phone (347) 390-1075

1153 1st Ave
New York, NY 10065
Phone (646) 386-2250

1264 Saint Nicholas Ave
Ste B
New York, NY 10033
Phone (718) 280-4188

5920 Myrtle Ave
Ridgewood, NY 11385
Phone (718) 504-6364

1045 W Jericho Tpke
Smithtown, NY 11787
Phone (631) 543-8844

1975 Hylan Blvd
Staten Island, NY 10306
Phone (718) 447-4900

Networks

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

Interoperability endpoints

  • Direct secure messaging: kanwar.gill@arn.eclinicaldirectplus.com
  • Direct secure messaging: kgill21622@direct.xtensys.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1790943694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 COMMACK RD STE 246",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST STE 6",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-994-1200",
            "fax_number": "631-994-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Commack Rd Ste 246",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117253442",
            "country_code": "US",
            "telephone_number": "631-352-0851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "KANWAR IQBAL",
        "middle_name": "SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "262723",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "262723",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "262723",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101263665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.