Gino A Consigliere, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

109169 Issued in NY

Practice address

7 Medical Dr Ste a
Port Jefferson Station, NY 11776-1593

Phone

(631) 928-5252

Fax

(631) 928-5259

NPI assigned

Dec 28, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Internal Medicine Associates, PC

  dba Medical Associates

  • Internal Medicine Physician
  • Oakland Gardens, NY
  • NPI 1619188489
  Medicare reassignment NPD
• Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Selden, NY
  • NPI 1134658693
  NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851457477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MEDICAL DR STE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761593",
            "telephone_number": "631-928-5252",
            "fax_number": "631-928-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MEDICAL DR STE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761593",
            "telephone_number": "631-928-5252",
            "fax_number": "631-928-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSIGLIERE",
        "first_name": "GINO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "109169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTH",
            "identifier": "182279",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "CCLI1312",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "GC0625781",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AJ45668",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITER HEALTHCARE",
            "identifier": "692668",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULITPLAN",
            "identifier": "P44353103",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.