Active NPI
David Theophilus Gursky, M.D.
- Anesthesiology Physician
- Elkhart, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01080119A
- Practice address
- 600 East Blvd
Elkhart, IN 46514-2483 - Phone
- (574) 294-2621
- NPI assigned
- Mar 29, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 288346 | NY | |
| Anesthesiology Physician | 207L00000X | 01080119A | IN | Primary |
Addresses
Primary practice location
600 East Blvd
Elkhart, IN 46514-2483
Mailing address
240 E Palisade Ave Apt 6B
Englewood, NJ 07631-3150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 E Blvd
Beacon Medical Group Anesthesia Elk
Elkhart, IN 46514-2483
Phone (574) 524-8130
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 288346 | NY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group Inc | Anesthesiology | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Current | Accepting new patients |
Locations
600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621
6913 N Main St
Granger, IN 46530
Phone (574) 647-1500
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524268800000",
"number": "1821331703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 E PALISADE AVE APT 6B",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076313150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 EAST BLVD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142483",
"telephone_number": "574-294-2621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURSKY",
"first_name": "DAVID",
"middle_name": "THEOPHILUS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-29",
"last_updated": "2018-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "288346",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01080119A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.