Individual provider Active NPI

Madeline Perie Gittleman, PSY.D.

  • Health Psychologist
  • New York, NY
National Provider Identifier
1003050626
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
License
019247 Issued in NY
Practice address
350 E 17TH St
Baird Hall, Room 12
New York, NY 10003-3805
Phone
(212) 844-1302
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Psychologist 103TH0004X 019247 NY Primary

Addresses

Primary practice location

350 E 17TH St
Baird Hall, Room 12
New York, NY 10003-3805

Mailing address

350 E 17TH St
Baird Hall, Room 12
New York, NY 10003-3805
Phone (212) 844-1426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110909002566 NY Practitioner - Clinical Psychologist 9638349202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 21, 2014 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

10 Union Sq E
Ste 4K
New York, NY 10003
Phone (212) 844-8930

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: madelinegittleman@nslijmedgr.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1003050626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E 17TH ST",
            "address_2": "BAIRD HALL, ROOM 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033805",
            "telephone_number": "212-844-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 17TH ST",
            "address_2": "BAIRD HALL, ROOM 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033805",
            "telephone_number": "212-844-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITTLEMAN",
        "first_name": "MADELINE",
        "middle_name": "PERIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": "019247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.