DR. GAVIN SMILEY GULLICKSON DO
NPI 1508493545
Radiology - Diagnostic Radiology in Syracuse, NY

Q: What is Gavin Gullickson's NPI number?

The NPI number for Gavin Gullickson is 1508493545. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Q: What is Gavin Gullickson's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Gavin Gullickson was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since March 26, 2020PECOS EnrolledAccepts Medicare Assignment

750 E ADAMS ST, SYRACUSE, NY 13210(315) 464-5189(315) 464-7494 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2025, May 17, 2025, Mar 26, 2020 (3 updates tracked since 2020).

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About Dr. Gavin Smiley Gullickson Do NPPES

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

DR. GAVIN SMILEY GULLICKSON DO (NPI 1508493545) is an individual diagnostic radiology provider in Syracuse, New York, licensed in New York (337231) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with University Hospital S U N Y Health Science Center, and maintains a secondary practice location in Poughkeepsie.

NPPES Registry Identity

NPI1508493545

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. GAVIN SMILEY GULLICKSONCredential: DO

Location Address750 E ADAMS STSyracuse, NY 13210-2306

Mailing Address224 Harrison St Ste 601Syracuse, NY 13202-3186 · (315) 464-5660 · Fax (315) 464-7695

Phone(315) 464-5189

Fax(315) 464-7494

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 26, 2020

Last NPPES UpdateJune 17, 20253 updates tracked since enumeration

NPPES CertifiedJune 17, 2025

✔ NPI 1508493545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in NY · 337231

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

750 E ADAMS ST, Syracuse, NY 13210

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Secondary Practice Location 1

Location 145 Reade PlPoughkeepsie, NY 12601-3947 · Phone (845) 790-2085

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gavin Smiley Gullickson Do 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 ID8820502925

PECOS Enrollment IDI20250710000423

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.

Hospital Affiliations CMS Care Compare

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

University Hospital S U N Y Health Science Center

Acute Care Hospitals · Syracuse, NY

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number330241

Location750 East Adams StreetSyracuse, NY 13210 · Onondaga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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.

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.

DAVID M KANTER MD

Physical Medicine & Rehabilitation