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

Individual provider Obstetrics & Gynecology Physician · NPI 1619917960

Gustavo Sanroman, MD is an Obstetrics/Gynecology in Port Jefferson Station, New York. Graduated from Pennsylvania State University College of Medicine in 1986, 40 years ago. Practices with University Associates in Obstetrics and Gynecology University Faculty, a 115-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
40
Trained at
Pennsylvania State University College of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5225 Route 347 Ste 70
Port Jefferson Station, NY 11776-2053
Phone: (800) 645-3203
Fax: (631) 474-9169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 173068 (NY)

Record details

NPI number1619917960
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 7, 2006
Last updated in NPPESMay 3, 2022
Certification dateMay 3, 2022

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolPENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 1986 (40 years in practice)
Group practice University Associates In Obstetrics And Gynecology University Faculty — 115 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Port Jefferson Station