Individual provider Active NPI

Gabriella Izzo, MD

  • Pediatrics Physician
  • Gansevoort, NY
National Provider Identifier
1922504653
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
339922 Issued in NY
Practice address
6 Mountain Ledge
Gansevoort, NY 12831-2588
Phone
(518) 584-0355
Fax
(518) 583-7665
NPI assigned
Apr 2, 2018
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 339922 NY Primary

Addresses

Primary practice location

6 Mountain Ledge
Gansevoort, NY 12831-2588

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227003667 NY Practitioner - Pediatric Medicine 5294085890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4 Malvern LN
Apt 103
Saratoga Springs, NY 12866-5582

6 Wellness Way
Suite 201
Latham, NY 12110-2156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339922NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC Pediatrics CurrentSince Mar 2, 2026 Accepting new patients
Community Care Physicians, PC Pediatrics Past Accepting new patients

Locations

6 Mountain Ledge
Ste 1
Gansevoort, NY 12831
Phone (518) 584-0355

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

Interoperability endpoints

  • Direct secure messaging: gabriella.izzo.npi1922504653.phpct@direct.optumcare.masshiway.net
  • Direct secure messaging: gabriella.izzo@xdr.hhchealthdirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1922504653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MOUNTAIN LEDGE",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128312588",
            "telephone_number": "518-584-0355",
            "fax_number": "518-583-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "GABRIELLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "339922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gansevoort, NY

Sources for this page

Verify at the official NPI Registry.