Peter Gardner, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

024317 Issued in CT

Practice address

92 Jordan LN
Stamford, CT 06903-3914

Phone

(203) 940-2995

Fax

(203) 547-6194

NPI assigned

Sep 29, 2005

Last updated

Mar 21, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2015 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8591/brand/1/csg/1/fhir/r4
• Direct secure messaging: peter.gardner.1@16244.direct.athenahealth.com

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.

• Gastroenterology Consultants, P.C.

  • Gastroenterology Physician
  • Stamford, CT
  • NPI 1053524876
  NPD
• Litchfield County Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Torrington, CT
  • NPI 1871513283
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1972590578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 JORDAN LANE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06903",
            "telephone_number": "203-940-2995",
            "fax_number": "203-547-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 JORDAN LN",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069033914",
            "telephone_number": "203-940-2995",
            "fax_number": "203-547-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "024317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ID #",
            "identifier": "010027907CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID #",
            "identifier": "25013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEATLHCARE ID #",
            "identifier": "061246885",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4125202",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID #",
            "identifier": "020183",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT CARE ID #",
            "identifier": "024317",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradford Walker Ganz, DMD
• Mingming Gao
• Leydy Diana Garcia, RDH
• Stephanie Garcia
• Peter Andrew Gardell, DDS
• Karl Garrett, LADC
• Jessica Rose Garrison, FNP-C
• Patricia Ann Garst, APRN
• Louis Gaston
• Gastroenterology Consultants, P.C.

• Specialist in Stamford, CT
• Providers in Stamford, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.