Gavin Setzen, MD - Medicare Otolaryngology in Albany, NY

Gavin Setzen, MD is a medicare enrolled "Otolaryngology" physician in Albany, New York. He graduated from medical school in 1987 and has 37 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Albany Ent And Allergy Services Pc and his current practice location is 123 Everett Rd, Albany, New York. You can reach out to his office (for appointments etc.) via phone at (518) 701-2000.

Gavin Setzen is licensed to practice in New York (license number 191506) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063419232.

Contact Information

Gavin Setzen, MD
123 Everett Rd,
Albany, NY 12205-1407
(518) 701-2000
(518) 701-2020

Map and Direction




Physician's Profile

Full NameGavin Setzen
GenderMale
SpecialityOtolaryngology
Experience37 Years
Location123 Everett Rd, Albany, New York
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Gavin Setzen graduated from medical school in 1987
  NPI Data:
  • NPI Number: 1063419232
  • Provider Enumeration Date: 07/03/2005
  • Last Update Date: 10/03/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 8921086083
  • Enrollment ID: I20040824001485

Medical Identifiers

Medical identifiers for Gavin Setzen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063419232NPI-NPPES
P00151895OtherNYRR MEDICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207YS0123XOtolaryngology - Facial Plastic Surgery 1915061 (New York)Secondary
207Y00000XOtolaryngology 191506 (New York)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Peter's HospitalAlbany, NYHospital
Albany Medical Center HospitalAlbany, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Albany Ent And Allergy Services Pc367855173635

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gavin Setzen allows following entities to bill medicare on his behalf.
Entity NameAlbany Ent & Allergy Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205838729
PECOS PAC ID: 3678551736
Enrollment ID: O20040713001489

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gavin Setzen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Gavin Setzen, MD
123 Everett Rd,
Albany, NY 12205-1407

Ph: (518) 701-2000
Gavin Setzen, MD
123 Everett Rd,
Albany, NY 12205-1407

Ph: (518) 701-2000

Reviews and Comments


Otolaryngology Doctors in Albany, NY

John P. Gavin, M.D.
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 50 New Scotland Ave Fl 2, Albany, NY 12208
Phone: 518-262-6240    Fax: 518-262-4223
Lawrence S Kaufman, MD
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 123 Everett Rd, Albany, NY 12205
Phone: 518-701-2000    Fax: 518-701-2020
Robert J Scagnelli,
Otolaryngology
Medicare: Medicare Enrolled
Practice Location: 123 Everett Rd, Albany, NY 12205
Phone: 518-701-2085    Fax: 518-701-2020
Allison Dawn Lupinetti, MD
Otolaryngology
Medicare: Medicare Enrolled
Practice Location: 35 Hackett Blvd, Albany, NY 12208
Phone: 518-262-5575    Fax: 518-262-5184
Dr. Jason Mouzakes, MD
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 35 Hackett Blvd, Albany, NY 12208
Phone: 518-262-5575    Fax: 518-262-5184
Dr. Stanley Shapshay, M.D
Otolaryngology
Medicare: Medicare Enrolled
Practice Location: 35 Hackett Blvd, Albany, NY 12208
Phone: 518-262-5575    Fax: 518-262-5184

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.