Individual provider Active NPI

Roberto Lo Gullo, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1922681824
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
310043-01 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(646) 920-1224
NPI assigned
Apr 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 310043-01 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

138 E 36TH St Apt 5a
New York, NY 10016-3507
Phone (646) 920-1224

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
I20210810001216 NY Practitioner - Diagnostic Radiology 1254735491 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbiadoctors/Newyork-PresbyterianimagingGroup PAC ID 6608141981, 106 clinicians
Columbia/Newyork-Presbyterian Advanced Imaging Inc.Group PAC ID 9436686458, 87 clinicians

Practice addresses (Care Compare)

51 W 51St St
Suite 300
New York, NY 10019-1951
Phone (212) 326-8518

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

722 W 168TH St
New York, NY 10032-3727
Phone (212) 342-2889

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.9 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
10

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310043-01NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Aug 26, 2024 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 26, 2024 Accepting new patients
Columbia/Newyork-Presbyterian Advanced Imaging Inc. CurrentSince Nov 23, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Aug 26, 2024 Accepting new patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

300 E 66th St
New York, NY 10065
Phone (347) 798-8856

630 W 168th St
#28
New York, NY 10032
Phone (212) 305-1948

722 W 168th St
New York, NY 10032
Phone (212) 305-6754

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

51 W 51st St
Ste 300
New York, NY 10019
Phone (212) 342-3666

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: uyz9003@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1922681824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 E 36TH ST APT 5A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163507",
            "telephone_number": "646-920-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "646-920-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO GULLO",
        "first_name": "ROBERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "310043-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.