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112 GVR MEDICAL, PC
NPI 1649315771
Family Medicine in Forest Hills, NY

Active since February 20, 2007
6960 108TH ST, SUITE 108, FOREST HILLS, NY 11375(718) 263-0200(718) 263-0205 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About 112 Gvr Medical, Pc NPPES

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

112 GVR MEDICAL, PC (NPI 1649315771) is a healthcare organization registered as a family medicine in Forest Hills, New York and active in the NPI registry since February 2007. The organization lists Ida Tetro, Owner, as its authorized official.

NPPES Registry Identity

NPI1649315771
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business Name112 GVR MEDICAL, PC
Location Address6960 108TH ST, SUITE 108Forest Hills, NY 11375-4323
Mailing Address6960 108th St, Suite 108Forest Hills, NY 11375-4323 · (718) 263-0200 · Fax (718) 263-0205
Phone(718) 263-0200
Fax(718) 263-0205
Organization SubpartNo
Authorized OfficialIda TetroOwner · (718) 263-0200
Enumeration DateFebruary 20, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1649315771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 220405
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6960 108TH ST, Forest Hills, NY 11375
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

112 Gvr Medical, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to 112 Gvr Medical, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ida Tetro, MD
Family Practice
NPI 1649315243
6960 108TH ST SUITE 108
Forest Hills, NY 11375
(718) 263-0200
✔ PECOS✔ Accepts MedicareSame address

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

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 112 Gvr Medical, PC's NPI number?

The NPI number for 112 Gvr Medical, PC is 1649315771. It was assigned to this organization in the NPPES registry on February 20, 2007.

Where is 112 Gvr Medical, PC located?

112 Gvr Medical, PC is located at 6960 108th St Suite 108, Forest Hills, NY 11375. The listed phone number is (718) 263-0200.

What is 112 Gvr Medical, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is 112 Gvr Medical, PC enrolled in Medicare?

Yes. 112 Gvr Medical, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through 112 Gvr Medical, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to 112 Gvr Medical, PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for 112 Gvr Medical, PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.