Individual provider Active NPI

Michael Ian Gazes

  • Foot & Ankle Surgery Podiatrist
  • West Haven, CT
National Provider Identifier
1962820522
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
950 Issued in CT
Practice address
950 Campbell Ave
VA CT Healthcare System - Surgical Service/112
West Haven, CT 06516-2770
Phone
(203) 932-5711
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N006822-1 NY
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 950 CT Primary

Addresses

Primary practice location

950 Campbell Ave
VA CT Healthcare System - Surgical Service/112
West Haven, CT 06516-2770

Mailing address

330 Orchard Street
Mob 207
New Haven, CT 06511
Phone (203) 789-3443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170802001938 CT Practitioner - Podiatry 8224359849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

226 Mill Hill Ave
Suite 3
Bridgeport, CT 06610-2826
Phone (203) 384-3976

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Home health agency, Milford, CT, CCN 077143
  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Yale New Haven Hospital Inpatient rehabilitation facility, Milford, CT, CCN 07T022

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue642
Removal of skin lesions1-10
Removal of nail tissue313
Removal or shaving of skin growth125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000950CTMDAddiction (Substance Use Disorder) Counselor
950CTMDFoot & Ankle Surgery Podiatrist
N006822-1NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Foot & Ankle Surgery CurrentSince Sep 1, 2017 Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

4 Devine St
#A
North Haven, CT 06473
Phone (203) 287-6900

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

950 Campbell Ave
West Haven, CT 06516

Interoperability endpoints

  • Direct secure messaging: mgazes157927@direct.ynhh.org

Organizations & group practices 1

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 9

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1962820522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ORCHARD STREET",
            "address_2": "MOB 207",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-789-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "VA CT HEALTHCARE SYSTEM - SURGICAL SERVICE/112",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZES",
        "first_name": "MICHAEL",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006822-1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.