Individual provider Active NPI

Gerry F. Gaviola, M.D.

  • Neurology Physician
  • Morris Plains, NJ
National Provider Identifier
1881761054
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA04509700 Issued in NJ
Practice address
59 Koch Ave
Morris Plains, NJ 07950-4400
Phone
(973) 538-1800
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA04509700 NJ Primary

Addresses

Primary practice location

59 Koch Ave
Morris Plains, NJ 07950-4400

Mailing address

1550 Park Ave
South Plainfield, NJ 07080-5565
Phone (973) 538-1800

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110614000761 NJ Practitioner - Psychiatry 5597942888 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235606400000",
    "number": "1881761054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 PARK AVE",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805565",
            "telephone_number": "973-538-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 KOCH AVE",
            "city": "MORRIS PLAINS",
            "state": "NJ",
            "postal_code": "079504400",
            "telephone_number": "973-538-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIOLA",
        "first_name": "GERRY",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA04509700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris Plains, NJ

Sources for this page

Verify at the official NPI Registry.