Organization Active NPI

Capital District Surgical Associates, P.L.L.C.

  • Surgery Physician
  • Troy, NY
National Provider Identifier
1902914526
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CAPITAL DISTRICT SURGICAL ASSOCIATES, P.L.L.C.
Practice address
2231 Burdett Ave
Suite 130
Troy, NY 12180-2447
Phone
(518) 272-0171
Fax
(518) 271-6580
NPI assigned
Aug 25, 2006
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. John Kevin Gebert, M.D.
Title
Partner
Phone
(518) 272-0171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

2231 Burdett Ave
Suite 130
Troy, NY 12180-2447

Mailing address

2231 Burdett Ave
Suite 130
Troy, NY 12180-2447
Phone (518) 272-0171

Other identifiers 1

IdentifierTypeStateIssuer
01752712MedicaidNY

National Provider Directory

National Provider Directory

Locations

2231 Burdett Ave
#130
Troy, NY 12180
Phone (518) 272-0172

2231 Burdett Ave
Ste 130
Troy, NY 12180
Phone (518) 272-0171

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1902914526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 BURDETT AVE",
            "address_2": "SUITE 130",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802447",
            "telephone_number": "518-272-0171",
            "fax_number": "518-271-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 BURDETT AVE",
            "address_2": "SUITE 130",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802447",
            "telephone_number": "518-272-0171",
            "fax_number": "518-271-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL DISTRICT SURGICAL ASSOCIATES, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "GEBERT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "518-272-0171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01752712",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.