Gangadhara R Kabbli, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

262909 Issued in NY

Practice address

1243 Pennsylvania Ave
Pine City, NY 14871

Phone

(607) 734-6281

Fax

(607) 734-4409

NPI assigned

Jan 31, 2007

Last updated

Jul 31, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• Guthrie Cortland Regional Medical Center Hospital, Cortland, NY, CCN 330175
• Oswego Hospital Hospital, Oswego, NY, CCN 330218
• Auburn Community Hospital Hospital, Auburn, NY, CCN 330235

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gkabbli2367124@direct.trinity-health.org

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.

• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070

  Internal Medicine

  NPD
• St Francis Hospital United States Catholic Conference

  dba St Francis Ekg

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1750439030
  NPD (past)
• Griffin Faculty Physicians, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Derby, CT
  • NPI 1598755605

  Internal Medicine

  NPD (past)

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

• Auburn Community Hospital

  • General Acute Care Hospital
  • Auburn, NY
  • NPI 1093712911
  Care Compare affiliation
• Guthrie Cortland Medical Center

  • General Acute Care Hospital
  • Cortland, NY
  • NPI 1740287531
  Care Compare affiliation
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1841337672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 PENNSYLVANIA AVE",
            "city": "PINE CITY",
            "state": "NY",
            "postal_code": "14871",
            "telephone_number": "607-734-6281",
            "fax_number": "607-734-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABBLI",
        "first_name": "GANGADHARA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "262909",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "262909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032498220002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03397880",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guthrie Clinic LTD (Guthrie Medical Group)
• Guthrie Medical Group, P.C.
• Andrea E Herman, RPA-C
• Inner Lakes Therapy PLLC
• Jennifer Share Midwifery and Tess Interlicchia Nurse Practitioner in F (Root to Rise Wellness Center)
• Vincent S Ladelia, MD
• William Ridge McClintic, D.O.
• Sean Kevin Noterfonzo
• Brenda Prins
• Leslie Scott Rachlin, MD

• Cardiovascular Disease Physician in Pine City, NY
• Providers in Pine City, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.

Verify at the official NPI Registry.