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DR. GERALD C SMALDONE M.D., PHD
NPI 1891710828
Internal Medicine - Pulmonary Disease in East Setauket, NY

Active since July 12, 2006PECOS EnrolledAccepts Medicare Assignment
98.52/100
CMS Quality Rating
26 RESEARCH WAY, EAST SETAUKET, NY 11733(631) 444-0580 Get Directions Write a Review

NPPES record last updated: April 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Gerald C Smaldone M.d., Phd NPPES

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

DR. GERALD C SMALDONE M.D., PHD (NPI 1891710828) is an individual pulmonary disease provider in East Setauket, New York, licensed in New York (142684) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and is a graduate of New York University School Of Medicine (1975).

NPPES Registry Identity

NPI1891710828
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. GERALD C SMALDONECredential: M.D., PHD
Location Address26 RESEARCH WAYEast Setauket, NY 11733
Mailing AddressP.o. Box 1559Stony Brook, NY 11790
Phone(631) 444-0580
Sole ProprietorNo
Medical School CMSNew York University School Of MedicineGraduated 1975
Enumeration DateJuly 12, 2006
Last NPPES UpdateApril 10, 2022
NPPES CertifiedApril 10, 2022
✔ NPI 1891710828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in NY · 142684
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
26 RESEARCH WAY, East Setauket, NY 11733
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Other Identifiers 3

Medicaid00524630NY
Other4496374NY · Aetna
Other38A75NY · Empire Bc.bs

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. Gerald C Smaldone M.d., Phd 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 ID7911049945
PECOS Enrollment IDI20100128000551
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 5

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.
135 services101 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
37 services35 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.
35 services35 patients
Test to measure the level of nitric oxide gas 95012
A test to measure the level of nitric oxide gas helps assess inflammation in the lungs, often linked with asthma. You'll breathe into a device, and it'll provide a reading of nitric oxide levels. This helps monitor and manage respiratory conditions.
23 services22 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.
22 services20 patients

Hospital Affiliations CMS Care Compare

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

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 11733 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
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

98.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.85
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers13 claims18 services$14.93 avg. paid by Medicare
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
5 suppliers72 claims72 services$66.12 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
3 suppliers49 claims49 services$36.03 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
7 suppliers17 claims2,869 services$0.03 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$32.76 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
8 suppliers17 claims17 services$24.45 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.

MS. HAKSOO KIM NURSE PRACTITIONER
Nurse Practitioner (Adult Health)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-0502
MS. JENNIFER M MULVEY FITZGERALD NP, CDE
Nurse Practitioner (Family)
26 RESEARCH WAY, SUITE 1
EAST SETAUKET, NY 11733
Suffolk County (914) 649-9993
DR. LEONARD ARBEIT M.D.
Internal Medicine (Nephrology)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-0580
DR. EDWARD NORD M.D.
Internal Medicine (Nephrology)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-0580
DR. RAJEEV BALWANT PATEL M.D.
Internal Medicine (Pulmonary Disease)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-9953
DR. HAROLD CARLSON M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-0580
DR. MOHAMED MOHSEN MANSOUR M.D.
Internal Medicine (Pulmonary Disease)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-1750
MRS. FATIMA SHEIKH D.O
Internal Medicine (Nephrology)
26 RESEARCH WAY
EAST SETAUKET, NY 11733
Suffolk County (631) 444-0580

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 Gerald Smaldone's NPI number?

The NPI number for Gerald Smaldone is 1891710828. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Where is Gerald Smaldone located?

Gerald Smaldone practices at 26 Research Way, East Setauket, NY 11733. The listed phone number is (631) 444-0580.

What is Gerald Smaldone's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Gerald Smaldone enrolled in Medicare?

Yes. Gerald Smaldone 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.

Is Gerald Smaldone affiliated with any hospitals?

According to CMS data, Gerald Smaldone is affiliated with Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Gerald Smaldone was last updated on April 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.