Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Gavin Smiley Gullickson, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1508493545

Dr. Gavin Smiley Gullickson, DO is a Diagnostic Radiology in Syracuse, New York. Qualified in 2020, 6 years ago. Practices with University Radiology Associates, LLP, a 41-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

750 E Adams St
Syracuse, NY 13210-2306
Phone: (315) 464-5189
Fax: (315) 464-7494
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 45 Reade Pl, Poughkeepsie, NY 12601-3947 — (845) 790-2085

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 337231 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1508493545
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMarch 26, 2020
Last updated in NPPESJune 17, 2025
Certification dateJune 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice University Radiology Associates, Llp — 41 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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