Individual provider Active NPI

Wolfgang G. Gilliar, DO

  • Physical Medicine & Rehabilitation Physician
  • Old Westbury, NY
National Provider Identifier
1922097302
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2337011 Issued in NY
Practice address
Northern Blvd
Academic Health Care Center Ny Institute of Technology
Old Westbury, NY 11568-8000
Phone
(516) 686-1300
Fax
(516) 686-7890
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2337011 NY Primary

Addresses

Primary practice location

Northern Blvd
Academic Health Care Center Ny Institute of Technology
Old Westbury, NY 11568-8000

Mailing address

Northern Blvd
Academic Health Care Center Ny Institute of Technology
Old Westbury, NY 11568-8000
Phone (516) 686-1300

Other identifiers 2

IdentifierTypeStateIssuer
1922097302OtherNYNPI NUMBER
1821048612OtherNYNPI GROUP NUMBER

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
2337011NYMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1922097302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER NY INSTITUTE OF TECHNOLOGY",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER NY INSTITUTE OF TECHNOLOGY",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAR",
        "first_name": "WOLFGANG",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "2337011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1922097302",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1821048612",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.