Evan Geller

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

170433 Issued in NY

Practice address

70 N Country Rd
Suite 203
Port Jefferson, NY 11777-2161

Phone

(631) 474-0707

Fax

(631) 474-4034

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• North Suffolk Surgical Assoc

  • Specialist
  • Port Jefferson, NY
  • NPI 1447414370
  NPD (past)
• Stony Brook Surgical Associates, University Faculty Practice Corporati

  • Surgery Physician
  • Stony Brook, NY
  • NPI 1063468536
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1972522811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ROUTE 25A",
            "address_2": "SUITE 225",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788556",
            "telephone_number": "631-474-0707",
            "fax_number": "631-474-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD",
            "address_2": "SUITE 203",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-474-0707",
            "fax_number": "631-474-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLER",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "170433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01033958",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candace Gandulla, MA CCC-SLP
• Michelle Garcia, MD
• Julianna Gaul
• Christina Gearges, M.D.
• Donna Lynn Geiger, M.D.
• Loreta Geneviciute, DDS
• Anthony Mark Giammarino, MD
• Mary Kathryn Giannico, PA
• Jagdish Gidwani, M.D.
• Olivia Katherine Gil, AU.D

• Surgery Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.