Active NPI
Andrew G Gaiziunas, MD
- Otolaryngology Physician
- Rockford, IL
National Provider Identifier
1871504415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Practice address
- 1415 E State St
Suite A6
Rockford, IL 61104-2333 - Phone
- (815) 962-6600
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | IL | Primary |
Addresses
Primary practice location
1415 E State St
Suite A6
Rockford, IL 61104-2333
Mailing address
1415 E State St
Suite A6
Rockford, IL 61104
Phone (815) 962-6600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-042881 | IL | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871504415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 E STATE ST",
"address_2": "SUITE A6",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61104",
"telephone_number": "815-962-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 E STATE ST",
"address_2": "SUITE A6",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042333",
"telephone_number": "815-962-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAIZIUNAS",
"first_name": "ANDREW",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.