Individual provider Active NPI

Charles L Garbo, M.D.

  • Hematology & Oncology Physician
  • Ithaca, NY
National Provider Identifier
1942363346
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
190523-1 Issued in NY
Practice address
201 Harris B Dates Dr
Suite 102
Ithaca, NY 14850-1345
Phone
(607) 272-5414
Fax
(607) 272-6121
NPI assigned
Dec 18, 2006
Last updated
Oct 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 190523-1 NY Primary

Addresses

Primary practice location

201 Harris B Dates Dr
Suite 102
Ithaca, NY 14850-1345

Mailing address

201 Harris B Dates Dr
Suite 102
Ithaca, NY 14850-1345
Phone (607) 272-5414

Other identifiers 1

IdentifierTypeStateIssuer
01383971MedicaidNY

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
I20040426001582 NY Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 4082601778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
University of Vermont College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Center at IthacaGroup PAC ID 7214847367, 34 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4443

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190523-1NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Center at Ithaca CurrentSince Mar 14, 2011 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients
Cayuga Medical Associates, PC CurrentSince Apr 1, 2014 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Mar 14, 2011 Accepting new patients
Ithaca Medical Group, PLLC CurrentSince Jan 1, 2002 Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

1301 Trumansburg Rd
Ste P
Ithaca, NY 14850
Phone (607) 272-5414

201 Harris B Dates Dr
Ste 102
Ithaca, NY 14850
Phone (607) 272-5414

310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100

Interoperability endpoints

  • Direct secure messaging: cgarbo20518@direct.xtensys.com
  • FHIR API: https://api.platform.athenahealth.com/14564/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1942363346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HARRIS B DATES DR",
            "address_2": "SUITE 102",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501345",
            "telephone_number": "607-272-5414",
            "fax_number": "607-272-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HARRIS B DATES DR",
            "address_2": "SUITE 102",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501345",
            "telephone_number": "607-272-5414",
            "fax_number": "607-272-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBO",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "190523-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01383971",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.