Gerardo Tolentino, M.D.

Primary specialty

Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X

License

206084 Issued in NY

Practice address

5 Medical Dr
Port Jefferson Station, NY 11776-1595

Phone

(631) 632-3785

NPI assigned

Jun 12, 2006

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Neurology Associates of Stony Brook, University Faculty Practice Corpo

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1699720888
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861434946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-632-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL DR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761595",
            "telephone_number": "631-632-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "206084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01805774",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5080569",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynnette Thompson, LPN
• Kayla Thorsen, OTR/L
• Three Village Neurology, P.C.
• Barbara Tierno
• Bernadette Marie Timko, OTR/L
• Alfredo Enrique Torres Gonzalez, M.D
• Ramon Torres
• Town Surgery Ny PLLC (Town Plastic Surgery)
• Linda Melanie Treudler
• Tri State Medical Associates PC

• Neurodevelopmental Disabilities Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Neurodevelopmental Disabilities 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.