Organization Active NPI

Gastrohealth Medical P.C.

  • Gastroenterology Physician
  • Jackson Heights, NY
National Provider Identifier
1851812440
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROHEALTH MEDICAL P.C.
Practice address
7134 Roosevelt Ave
Jackson Heights, NY 11372-6137
Phone
(347) 738-5700
NPI assigned
Jul 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Dr. Raghav Bansal, M.D.NPI 1144547050
Title
President
Phone
(347) 738-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

7134 Roosevelt Ave
Jackson Heights, NY 11372-6137

Mailing address

63 Cresthollow LN
Albertson, NY 11507-1046

Other identifiers 1

IdentifierTypeStateIssuer
04816377MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170925001363 NY Part B Supplier - Clinic/Group Practice 3870867294 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson Heights, NY

National Provider Directory

National Provider Directory

Locations

6413 Broadway
Woodside, NY 11377
Phone (718) 205-6561

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEDHAD

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1851812440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 CRESTHOLLOW LN",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7134 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726137",
            "telephone_number": "347-738-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROHEALTH MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "BANSAL",
        "authorized_official_first_name": "RAGHAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-738-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04816377",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.