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CARL K GJERTSON M.D.
NPI 1063472017
Urology in Farmington, CT

Active since March 24, 2006PECOS EnrolledAccepts Medicare Assignment
263 FARMINGTON AVE, UROLOGY, FARMINGTON, CT 06030(860) 679-4100(860) 679-1390 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 12, 2025, Jul 11, 2022 (2 updates tracked since 2022).

About Carl K Gjertson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARL K GJERTSON M.D. (NPI 1063472017) is an individual urology provider in Farmington, Connecticut, licensed in New Jersey (25MA12258300) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Cape Regional Medical Center Inc, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1063472017
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameCARL K GJERTSONCredential: M.D.
Location Address263 FARMINGTON AVE, UROLOGYFarmington, CT 06030-6227
Mailing Address331 Newman Springs Road Bldg. 2, Suite 220Red Bank, NJ 07701 · (732) 807-0877 · Fax (201) 751-1680
Phone(860) 679-4100
Fax(860) 679-1390
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 2001
Enumeration DateMarch 24, 2006
Last NPPES UpdateNovember 12, 20252 updates tracked since enumeration
NPPES CertifiedNovember 12, 2025
✔ NPI 1063472017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Licenses✔ Licensed in NJ · 25MA12258300✔ Licensed in CT · 045171
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Also ListedUrology · Pediatric UrologyTaxonomy 2088P0231X · License 045171 (CT)
263 FARMINGTON AVE, Farmington, CT 06030
Open in Google Maps ↗

Secondary Practice Locations 4

Location 11145 Beacon Ave Ste AManahawkin, NJ 08050-2471 · Phone (609) 597-1991 · Fax (609) 597-8198
Location 21301 Route 72 W Ste 260Manahawkin, NJ 08050-2483 · Phone (609) 597-1991 · Fax (609) 597-8198
Location 31173 Beacon Ave Ste BManahawkin, NJ 08050-2531 · Phone (609) 597-1991 · Fax (609) 978-4860
Location 4279 Mathistown RdLittle Egg Harbor Twp, NJ 08087-4021 · Phone (609) 597-1991 · Fax (609) 978-4860

Other Identifiers 1

Medicaid1063472017CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carl K Gjertson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890707822
PECOS Enrollment IDI20240814001487
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Carl Gjertson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hackensack Meridian Health Medical Group - Specialty Care PC
118 mi
Surgical Critical Care
331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701
  • Reassigned Medicare billing, New Jersey enrollment
  • 2,844 clinicians in this Medicare group
NPI 1215989249 (732) 807-0800
Jersey Urology Group P. A.
191 mi
Urology
403 BETHEL RD
Somers Point, NJ 08244
  • Reassigned Medicare billing, New Jersey enrollment
  • 9 clinicians in this Medicare group
NPI 1225193162 (609) 927-8746
Shore Specialty Consultants
192 mi
Multi-Specialty
649 SHORE RD
Somers Point, NJ 08244
  • Reassigned Medicare billing, New Jersey enrollment
  • 51 clinicians in this Medicare group
NPI 1962808519 (609) 653-3500
Cape Physicians Associates PA
211 mi
Internal Medicine
11 VILLAGE DR
Cape May Court House, NJ 08210
  • Reassigned Medicare billing, New Jersey enrollment
  • 111 clinicians in this Medicare group
NPI 1003805227 (609) 465-2273

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
76 services71 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
73 services66 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
46 services40 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
36 services36 patients
Imaging of urinary tract following injection of a contrast agent 74420
This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.
34 services28 patients
Simple insertion of temporary bladder tube 51702
This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.
26 services15 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cape Regional Medical Center Inc

Acute Care Hospitals · Cape May Court House, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310011
LocationTwo Stone Harbor BlvdCape May Court House, NJ 08210 · Cape May County
Emergency services

Shore Medical Center

Acute Care Hospitals · Somers Point, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310047
Location100 Medical Center WaySomers Point, NJ 08244 · Atlantic County
Emergency services Birthing friendly

Southern Ocean Medical Center

Acute Care Hospitals · Manahawkin, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310113
Location1140 Rt 72 WManahawkin, NJ 08050 · Ocean County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
1 supplier13 claims3,360 services$6.18 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STATE OF CONNECTICUT HEALTH CENTER
Pathology (Anatomic Pathology & Clinical Pathology)
263 FARMINGTON AVE, LABORATORY HBP GROUP
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-7503
MR. IAN THOMAS MCNEILL
Neurological Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-8080
DR. LUIS CHAVEZ DE PAZ DDS, MS, PHD
Dentist (Endodontics)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-2719
TARUNYA REDDY VEDERE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3245
ZACHARY TALLENT SOLOMON
Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467
MICHAEL CONNOLLY
Psychiatry & Neurology (Psychiatry)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-4733
EMILY WENG DO
Internal Medicine (Gastroenterology)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3158
ANDREW KEMERLEY DO
Student in an Organized Health Care Education/Training Program
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carl Gjertson's NPI number?

The NPI number for Carl Gjertson is 1063472017. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Where is Carl Gjertson located?

Carl Gjertson practices at 263 Farmington Ave Urology, Farmington, CT 06030. The listed phone number is (860) 679-4100.

What is Carl Gjertson's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Carl Gjertson enrolled in Medicare?

Yes. Carl Gjertson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Carl Gjertson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carl Gjertson reassigns Medicare benefits to 4 organizations: Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ), Jersey Urology Group P. A. (Somers Point, NJ), Shore Specialty Consultants (Somers Point, NJ) and Cape Physicians Associates PA (Cape May Court House, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carl Gjertson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carl Gjertson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Carl Gjertson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carl Gjertson affiliated with any hospitals?

According to CMS data, Carl Gjertson is affiliated with Cape Regional Medical Center Inc, Shore Medical Center and Southern Ocean Medical Center.

When was this NPI record last updated?

The NPPES record for Carl Gjertson was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.