Individual provider Active NPI

Gloria S Escobar, MD

  • Family Medicine Physician
  • Islip, NY
National Provider Identifier
1992978654
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
249522 Issued in NY
Practice address
148 Islip Avenue
Suite 27
Islip, NY 11751
Phone
(631) 650-6580
Fax
(631) 650-6578
NPI assigned
Apr 2, 2008
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 249522 NY Primary
Family Medicine Physician 207Q00000X 249544 NY

Addresses

Primary practice location

148 Islip Avenue
Suite 27
Islip, NY 11751

Mailing address

148 Islip Avenue
Suite 27
Islip, NY 11751
Phone (631) 650-6580

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000281 NY Practitioner - Family Practice 2567517618 Practice locations: Islip, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

148 Islip Ave
Suite 27
Islip, NY 11751-3226
Phone (631) 560-6580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249522NYMDFamily Medicine Physician
249544NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vytaliz Medical CurrentSince Jan 1, 2021 Accepting new patients
Nassau Suffolk Medical Practice, P.C. Family Medicine Past Accepting new patients

Locations

3 E Evergreen Rd
Ste 1017
New City, NY 10956
Phone (201) 565-2533

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1992978654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 ISLIP AVENUE",
            "address_2": "SUITE 27",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "11751",
            "telephone_number": "631-650-6580",
            "fax_number": "631-650-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 ISLIP AVENUE",
            "address_2": "SUITE 27",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "11751",
            "telephone_number": "631-650-6580",
            "fax_number": "631-650-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR",
        "first_name": "GLORIA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "249522",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "249544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

Verify at the official NPI Registry.