NPIMap

Individual provider Active NPI

Gary Tannenbaum, MD

  • Vascular Surgery Physician
  • Bronxville, NY
National Provider Identifier
1811949670
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
160375 Issued in NY
Practice address
1 Pondfield Rd Ste 202
Bronxville, NY 10708-3706
Phone
(914) 965-2606
Fax
(914) 965-2880
NPI assigned
May 17, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 160375 NY
Vascular Surgery Physician 2086S0129X 160375 NY Primary

Addresses

Primary practice location

1 Pondfield Rd Ste 202
Bronxville, NY 10708-3706

Mailing address

1 Pondfield Rd Ste 202
Bronxville, NY 10708-3706
Phone (914) 965-2606

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address tannenb@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117001271 NY Practitioner - Vascular SurgeryPractitioner - General Surgery 8527022698 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Columbia University College of Physicians and Surgeons, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJR Medical, PCGroup PAC ID 5991608440, 43 clinicians

Practice addresses (Care Compare)

967 N Broadway
Yonkers, NY 10701-1301
Phone (914) 964-4444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal31
Leg revascularization (restoring blood flow)33
Removal of tissue266

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Westchester Medical Practice, PC CurrentSince Dec 5, 2018 Accepting new patients
The Trustees of Columbia University in the City of New York Surgery CurrentSince Jan 1, 2015 Accepting new patients
SJR Medical, PC CurrentSince Oct 1, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Surgery CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
The Westchester Medical Practice, PC CurrentSince Dec 5, 2018 Accepting new patients
David E. Bank, M.D., P.C. PastSince Feb 13, 1997 Accepting new patients

Locations

3219 E Tremont Ave
#2
Bronx, NY 10461
Phone (718) 792-7625

1 Pondfield Rd
Ste 202
Bronxville, NY 10708
Phone (914) 695-2606

1978 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 293-8450

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

128 Ashford Ave
Fl 2
Dobbs Ferry, NY 10522
Phone (914) 693-6500

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

1019 Yonkers Ave
Yonkers, NY 10704
Phone (612) 644-9447

1022 N Broadway
Yonkers, NY 10701
Phone (914) 963-0284

1088 N Broadway
Yonkers, NY 10701
Phone (914) 964-4965

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

984 N Broadway
Ste 501
Yonkers, NY 10701
Phone (914) 636-1700

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

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

Interoperability endpoints

  • Direct secure messaging: gary.tannenbaum.p97@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: garyt@stjohnsmedicalpc.directmedgenehr.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1811949670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PONDFIELD RD STE 202",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083706",
            "telephone_number": "914-965-2606",
            "fax_number": "914-965-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PONDFIELD RD STE 202",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083706",
            "telephone_number": "914-965-2606",
            "fax_number": "914-965-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "160375",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "160375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1 Pondfield Rd Ste 202",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1 Pondfield Rd Ste 202",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tannenb@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "1 Pondfield Rd Ste 202",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

Verify at the official NPI Registry.