Individual provider Active NPI

James G Gardiner, DPM

  • Podiatrist
  • Monticello, NY
National Provider Identifier
1922190636
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004633 Issued in NY
Practice address
427 Broadway
Suite 2
Monticello, NY 12701-1742
Phone
(845) 794-7741
Fax
(845) 794-0228
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004633 NY Primary

Addresses

Primary practice location

427 Broadway
Suite 2
Monticello, NY 12701-1742

Mailing address

427 Broadway
Suite 2
Monticello, NY 12701-1742
Phone (845) 794-7741

Other identifiers 1

IdentifierTypeStateIssuer
01158754MedicaidNY

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506000307 NY Order and Referring Only - PodiatryPractitioner - Podiatry 5890861983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004633NYMDPsychologist
N004633NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1922190636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 BROADWAY",
            "address_2": "SUITE 2",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011742",
            "telephone_number": "845-794-7741",
            "fax_number": "845-794-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 BROADWAY",
            "address_2": "SUITE 2",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011742",
            "telephone_number": "845-794-7741",
            "fax_number": "845-794-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "JAMES",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01158754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, NY

Sources for this page

Verify at the official NPI Registry.