GUSTAVO SANROMAN M.D.
NPI 1619917960
Obstetrics & Gynecology in Port Jefferson Station, NY

Q: What is the provider's specialty?

The provider's specialty is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since June 07, 2006PECOS EnrolledAccepts Medicare Assignment

98.52/100

CMS Quality Rating

5225 ROUTE 347, SUITE 70, PORT JEFFERSON STATION, NY 11776(800) 645-3203(631) 474-9169 Get Directions Write a Review

NPPES record last updated: May 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 3, 2022, Feb 8, 2019 (2 updates tracked since 2019).

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About Gustavo Sanroman M.d. NPPES

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

GUSTAVO SANROMAN M.D. (NPI 1619917960) is an individual obstetrics & gynecology provider in Port Jefferson Station, New York, licensed in New York (173068) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of Pennsylvania State University College Of Medicine (1986).

NPPES Registry Identity

NPI1619917960

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameGUSTAVO SANROMANCredential: M.D.

Location Address5225 ROUTE 347, SUITE 70Port Jefferson Station, NY 11776-2053

Mailing Address45 Research Way Ste 105East Setauket, NY 11733-6401 · (631) 675-2125 · Fax (631) 675-2628

Phone(800) 645-3203

Fax(631) 474-9169

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 1986

Enumeration DateJune 7, 2006

Last NPPES UpdateMay 3, 20222 updates tracked since enumeration

NPPES CertifiedMay 3, 2022

✔ NPI 1619917960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in NY · 173068

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

5225 ROUTE 347, Port Jefferson Station, NY 11776

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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

Gustavo Sanroman 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 ID4688630999

PECOS Enrollment IDI20041208000820

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 6

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.

62 services48 patients

Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina 76830

An ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.

57 services51 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

37 services37 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

30 services29 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

23 services20 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.

20 services20 patients

Hospital Affiliations CMS Care Compare 2

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

John T Mather Memorial Hospital Of Port Jefferson

Acute Care Hospitals · Port Jefferson, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330185

Location75 North Country RoadPort Jefferson, NY 11777 · Suffolk County

Emergency services

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number330393

LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11776 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

$154.28 typical visit price

range $67.40 – $203.53

Typical copayment $38.57 (range $16.85 – $50.88)

Most-billed visit code 99204

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

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.

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.

98.52/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.85

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 2

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

DR. NICHOLAS JOHN NICASTRO D.D.S.

Dentist (General Practice)

5225 ROUTE 347, SUITE 52
PORT JEFFERSON STATION, NY 11776

Suffolk County (631) 928-2020

DR. NICHOLAS JOHN NICASTRO JR. D.D.S.