Individual provider Active NPI

Gary Seymour Schneiderman, D.M.D.

  • General Practice Dentistry
  • Jersey City, NJ
National Provider Identifier
1811020043
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16353 Issued in NJ
Practice address
895 Bergen Ave
Jersey City, NJ 07306-4309
Phone
(201) 653-7886
Fax
(201) 653-2266
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16353 NJ Primary

Addresses

Primary practice location

895 Bergen Ave
Jersey City, NJ 07306-4309

Mailing address

PO Box 6436
Jersey City, NJ 07306-0436
Phone (201) 653-7886

Other identifiers 1

IdentifierTypeStateIssuer
2094801MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150610002100 NJ Order and Referring Only - DentistPractitioner - Dentist 2567783939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16353NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Schneiderman, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1811020043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6436",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073060436",
            "telephone_number": "201-653-7886",
            "fax_number": "201-653-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064309",
            "telephone_number": "201-653-7886",
            "fax_number": "201-653-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDERMAN",
        "first_name": "GARY",
        "middle_name": "SEYMOUR",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "16353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2094801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.