Directions

Valley Stream, NY

210 E. Sunrise Hwy., Suite 304, Valley Stream, NY 11581

516-265-7049

Directions

Glendale, NY

78-01 Myrtle Ave., Glendale, NY 11385

516-265-7049

Directions

  • Covid-19 Update:

    We are open and seeing patients in our office. We have taken several measures to insure your safety and the safety of our staff. You will be asked several COVID-19 screening questions when you make an appointment and when you come to the office. Wearing of mask is mandatory. If you need to have a procedure, a COVID-19 nasal swab PCR test will be required within 72 hours of the test. Please bring all your reports to the office if you have had previous testing. To read more please Click Here

    Please note that we are also offering Telemedicine as a service to our patients, caring for their needs remotely. We have been serving NY for over 30 years. We want everyone to feel safe and satisfied after their visit. If you have suggestions how we can improve please talk to the doctors or staff.

    Bradley Rieders,M.D.
    Gautam Reddy,M.D.
    Brandon Rieders,M.D.

  • Home
  • About Us
    • Meet Our Doctors
    • Social
  • Conditions Treated
      • Abdominal Pain & Bloating
      • Acid Reflux
      • Bile Duct Disorder
      • Bloating
      • Celiac Disease
      • Colon Cancer
      • Constipation
      • Crohns Disease
      • Diarrhea
      • Difficulty Swallowing
      • Diverticulitis
      • Gallbladder Problems / Gallbladder Disease
      • Hemorrhoid Treatment
      • Hepatitis
      • Hepatitis C
      • Inflammatory Bowel Disease
      • Irritable Bowel Syndrome
      • Lactose Intolerance
      • Liver Disease
      • Nutrition
      • Obesity
      • Rectal Pain & Bleeding Treatment
      • Ulcerative Colitis
      • Unexplained Weight Loss
  • Office Procedures
      • Hemorrhoids
      • Colonoscopy
      • Lactose Intolerance Test
      • Capsule endoscopy
      • Upper Endoscopy
      • Fructose Malabsorption Test
      • 48 hour Ph testing by Bravo
      • Bacteria Overgrowth Test
  • Patient Info
    • Procedure Instructions
    • Patient Forms
    • Billing / Insurance
    • Patient Survey
  • Testimonials
  • Blog
  • Contact
  • Locations
    • Valley Stream, NY
    • Glendale, NY
GastroCare LI
GastroCare LI
516-265-7049
Make an Appointment
Directions
  • Valley Stream, NY
  • Glendale, NY

Step 1 of 3

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  • PATIENT QUESTIONNAIRE


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  • Please provide us with a telephone number of a relative or friend in case of emergency
  • **to be filled out in office**

  • ACKNOWLEDGEMENT OF RECIEPT OF NOTICE OF PRIVACY PRACTICES

    GASTRCOARE LI RESERVES THE RIGHT TO MODIFY THE PRIVACY PRACTICES OUTLINED IN THE NOTICE

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  • **to be filled out in office**

  • PERMISSION FOR DISCLOSURE OF HEALTH INFORMATION

    Verification of Family / Friend

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  • TO DISCUSS MY PRIVATE HEALTH INFORMATION WITH

  • You have the right to change this disclosure of medical history at any time, as long as you notify this office in writing

  • **to be filled out in office**

  • AUTHORIZATION FOR USE OF SIGNATURE ON FILE ASSIGNMENT OF BENEFITS

    The undersigned hereby assigns all monetary benefits to be received by me from any individual, insurance company, or other person or organization as a result of any medical treatment or related services rendered to me by GastroCare LI, partial or full payment directly to GastroCare LI of such benefits.

    I also authorize the release of any medical or other information necessary to process claims, I authorize payment of medical benefits to GastroCare LI physicians or suppliersfor all services rendered to me using “SIGNATURE ON FILE”. I request that payment of authorized Medicare benefits be made either to me or on my behalf to GastroCare LI for services furnised to me by the provider
    I authorize any holder of medical information about me to release to the Health Care Financing Admininistration and its agents any information needed to determine these benefits of the benefits payable for related services.

    This agreement is applicable to all services rendered by GastroCare LI at any future date so long as I do not cancel this agreement in writing.

    Due to the ever-changing coverage of insurance plans, in order to accommodate all our patients, we will continue to participate with many managed care plans. However, you
    are responsible for knowing the benefits and exclusions of your plan. It will be your responsibility to provide us with complete and accurate insurance information. As always, we will file the claim, but any procedure not covered by
    your plan will be your responsibility.

    Thank you in advance for your anticipated cooperation in this matter


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  • GastroCare LI – Medical History Form








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  • Please list all medication (prescriptions, OTC, Herbs, Etc) you are presently taking.
    *** Please include Aspirin, Advil or any blood thinner type of medication***










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  • Please circle if you have had problems in the past or are presently diagnosed with any the following



































  • Family History

  • Social History

  • Inquiry

  • If you are interested in meeting with our Nutritionist on staff please notify the receptionist.






Location Info & Directions

Valley Stream, NY

210 E. Sunrise Hwy., Suite 304, Valley Stream, NY 11581

516-265-7049

Glendale, NY

78-01 Myrtle Ave., Glendale, NY 11385

516-265-7049


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