Active NPI
Gary I Povill, MD
- Ophthalmology Physician
- Lake Katrine, NY
National Provider Identifier
1801898978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 120418
- Practice address
- 1561 Route 9W
Lake Katrine, NY 12449-5410 - Phone
- (845) 231-5600
- Fax
- (845) 231-5489
- NPI assigned
- Jun 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 120418 | NY | Primary |
Addresses
Primary practice location
1561 Route 9W
Lake Katrine, NY 12449-5410
Mailing address
600 Westage Business Ctr Dr
Fishkill, NY 12524-2281
Phone (845) 231-5600
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120418 | NY | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411516800000",
"number": "1801898978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 WESTAGE BUSINESS CTR DR",
"city": "FISHKILL",
"state": "NY",
"postal_code": "125242281",
"telephone_number": "845-231-5600",
"fax_number": "845-231-5489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1561 ROUTE 9W",
"city": "LAKE KATRINE",
"state": "NY",
"postal_code": "124495410",
"telephone_number": "845-231-5600",
"fax_number": "845-231-5489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POVILL",
"first_name": "GARY",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-02",
"last_updated": "2014-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "120418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Katrine, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.