Individual provider Active NPI

Bret D. Gelder, DDS,MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Schenectady, NY
National Provider Identifier
1972557999
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
047593 Issued in NY
Practice address
1070 Nott St
Schenectady, NY 12308-2410
Phone
(518) 374-9109
Fax
(518) 374-1978
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 047593 NY Primary

Addresses

Primary practice location

1070 Nott St
Schenectady, NY 12308-2410

Mailing address

1070 Nott St
Schenectady, NY 12308-2410
Phone (518) 374-9109

Other identifiers 3

IdentifierTypeStateIssuer
9175734OtherNYDORAL DENTAL
1007-4714OtherNYCDPHP
02624431MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731016528 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698787380

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972557999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082410",
            "telephone_number": "518-374-9109",
            "fax_number": "518-374-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082410",
            "telephone_number": "518-374-9109",
            "fax_number": "518-374-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELDER",
        "first_name": "BRET",
        "middle_name": "D.",
        "credential": "DDS,MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "047593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "9175734",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "1007-4714",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02624431",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.