Edison Genaro Gavilanes, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

257788 Issued in NY

Practice address

317 Broadway Ste a
Amityville, NY 11701-2770

Phone

(631) 598-5864

NPI assigned

Jul 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Amityville Pulmonology PLLCGroup PAC ID 2567471139, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Merit-based Incentive Payment System (MIPS)

Final score

77.48 of 100Reported as group

Quality

44.32

Improvement activities

40

Cost

69.51

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Amityville Pulmonology PLLC

  • Pulmonary Disease Physician
  • Amityville, NY
  • NPI 1154423622
  Medicare reassignment Care Compare group NPD
• Island Pulmonary and Critical Care PLLC

  • Pulmonary Disease Physician
  • Lake Grove, NY
  • NPI 1396543351
  Medicare reassignment NPD Authorized official
• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  NPD (past)
• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation
• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1992967731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56-45 MAIN STREET",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 BROADWAY STE A",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012770",
            "telephone_number": "631-598-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVILANES",
        "first_name": "EDISON",
        "middle_name": "GENARO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "257788",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "257788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Gang
• Anthony Gerard Garcia, M.D.
• Jorge L. Gardyn, M.D.
• Tricia Marie Gates
• Denae Gatling
• Geetha Balamurugan,D.D.S.,P.C.
• Shine George
• Waheed U Ghauri, RPH
• Ibrahim Mostafa Ghobashy, DENTAL DEGREE DDS
• Piya Ghoshal, M.D.

• Pulmonary Disease Physician in Amityville, NY
• Providers in Amityville, NY by specialty
• Pulmonary Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.