Gary W. Theall, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

1817741 Issued in NY

Practice address

55 Ronald Reagan Blvd
Warwick, NY 10990-4105

Phone

(845) 986-4949

Fax

(845) 986-9388

NPI assigned

Aug 29, 2005

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1982697611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109900350",
            "telephone_number": "845-986-4949",
            "fax_number": "845-986-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 RONALD REAGAN BLVD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904105",
            "telephone_number": "845-986-4949",
            "fax_number": "845-986-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEALL",
        "first_name": "GARY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "1817741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01184569",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edith K Tannar, LCSW CASAC
• Ashley J. Tanzosh, MS, NCC, LPC
• Carol P Taylor, M.D.
• The Herbert Kania Pediatric Group
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• Annmarie Thiessen
• Marc O Tiller, M.D.
• Timur Lokshin LMT, Lac, PC.
• Transportation Services of Orange County, Inc.
• Trauma and Resiliency Resources, Inc.

• Surgery Physician in Warwick, NY
• Providers in Warwick, 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 13, 2026; 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.