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DR. NICHOLAS GAETO DO
NPI 1538784178
Internal Medicine in Philadelphia, PA

Active since June 09, 2020PECOS Enrolled
100/100
CMS Quality Rating
5501 OLD YORK RD, PALEY 4320, PHILADELPHIA, PA 19141(212) 456-9142(215) 456-9052 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 8, 2024, Oct 25, 2023, Oct 6, 2023 and 3 more (6 updates tracked since 2020).

About Dr. Nicholas Gaeto Do NPPES

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

DR. NICHOLAS GAETO DO (NPI 1538784178) is an individual internal medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OS021734) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, is affiliated with Albert Einstein Medical Center, and is a graduate of Touro Un Col Of Osteopathic Medicine, New York (2020).

NPPES Registry Identity

NPI1538784178
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. NICHOLAS GAETOCredential: DO
Location Address5501 OLD YORK RD, PALEY 4320Philadelphia, PA 19141-3018
Mailing Address5501 Old York Rd, Paley 4320Philadelphia, PA 19141-3018 · (215) 456-9142 · Fax (215) 456-9052
Phone(212) 456-9142
Fax(215) 456-9052
Sole ProprietorNo
Medical School CMSTouro Un Col Of Osteopathic Medicine, New YorkGraduated 2020
Enumeration DateJune 9, 2020
Last NPPES UpdateAugust 8, 20246 updates tracked since enumeration
NPPES CertifiedAugust 8, 2024
✔ NPI 1538784178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in PA · OS021734✔ Licensed in NJ · 25MB12017000✔ Licensed in NY · 321353
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5501 OLD YORK RD, Philadelphia, PA 19141
Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas Gaeto Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577964311
PECOS Enrollment IDI20240821000120
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.

Areas of Expertise CMS Part B claims 11

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 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.
175 services114 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
92 services24 patients
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.
89 services68 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
85 services71 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
26 services26 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.
26 services26 patients

Hospital Affiliations CMS Care Compare

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

Albert Einstein Medical Center

Acute Care Hospitals · Philadelphia, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390142
Location5501 Old York RoadPhiladelphia, PA 19141 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.8
Promoting Interoperability100
Improvement Activities40

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.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier16 claims16 services$67.30 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.

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

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 Nicholas Gaeto's NPI number?

The NPI number for Nicholas Gaeto is 1538784178. It was assigned to this individual provider in the NPPES registry on June 9, 2020.

Where is Nicholas Gaeto located?

Nicholas Gaeto practices at 5501 Old York Rd Paley 4320, Philadelphia, PA 19141. The listed phone number is (212) 456-9142.

What is Nicholas Gaeto's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nicholas Gaeto enrolled in Medicare?

Yes. Nicholas Gaeto is registered in the Medicare PECOS enrollment system.

What insurance does Nicholas Gaeto accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Nicholas Gaeto 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 Nicholas Gaeto affiliated with any hospitals?

According to CMS data, Nicholas Gaeto is affiliated with Albert Einstein Medical Center.

When was this NPI record last updated?

The NPPES record for Nicholas Gaeto was last updated on August 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.