NPIMap

Individual provider Active NPI

Michael Gottesman, M.D.

  • Diagnostic Neuroimaging (Radiology) Physician
  • Bronx, NY
National Provider Identifier
1003203910
Registry record updated Dec 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Radiology) PhysicianTaxonomy code 2085D0003X
License
25MA11610900 Issued in NJ
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-5506
NPI assigned
Apr 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 25MA11610900 NJ Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230424000411 NJ Practitioner - Diagnostic Radiology 7214305655 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Radiology Group LLCGroup PAC ID 6608868500, 239 clinicians
Jersey Shore Imaging LLCGroup PAC ID 1355408212, 148 clinicians
University Radiology at Cooper LLCGroup PAC ID 4587053699, 78 clinicians
University Radiology at Trinitas LLCGroup PAC ID 9133174634, 126 clinicians
University Radiology-Atlantic, LLCGroup PAC ID 6901059864, 144 clinicians

Practice addresses (Care Compare)

1043 W Main St
Freehold, NJ 07728-2538
Phone (732) 462-1900

2100 Corlies Ave
Neptune, NJ 07753-6102
Phone (732) 988-1234

2339 Route 70 W
Cherry Hill, NJ 08002-3315
Phone (732) 390-0040

415 Morris Ave
Elizabeth, NJ 07208-3612
Phone (908) 351-7600

48 N Gilbert St
Tinton Falls, NJ 07701-4905
Phone (732) 530-5750

483 Cranbury Rd
East Brunswick, NJ 08816-3610
Phone 73239000402022

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038
  • Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074
  • Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

Merit-based Incentive Payment System (MIPS)

Final score
96.21 of 100Reported as group
Quality
95.54
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as group
Quality
85.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.93 of 100Reported as group
Quality
95.96
Improvement activities
40
Cost
73.85

Merit-based Incentive Payment System (MIPS)

Final score
96.51 of 100Reported as group
Quality
95.9
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
86.64
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA11610900NJMDDiagnostic Neuroimaging (Radiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Radiology-Atlantic, LLC CurrentSince May 1, 2023 Accepting new patients
University Radiology at Cooper, LLC CurrentSince May 1, 2023 Accepting new patients
Hillsborough Radiology Centers, LLC Current Accepting new patients
University Radiology at Trinitas, LLC CurrentSince May 1, 2023 Accepting new patients
Rwjuh Imaging at Plum Street, LLC CurrentSince May 1, 2023 Accepting new patients
Jersey Shore Imaging, LLC CurrentSince May 1, 2023 Accepting new patients
Central Jersey Radiologists Past Accepting new patients

Locations

1 Robertson Dr
Ste 16
Bedminster, NJ 07921
Phone (908) 234-0205

33 Monroe St
Bridgewater, NJ 08807
Phone (908) 725-1291

2339 Route 70 W
Cherry Hill, NJ 08002
Phone (856) 406-4080

579A Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

483 Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

3900 Park Ave
Ste 107
Edison, NJ 08820
Phone (732) 546-6800

415 Morris Ave
Elizabeth, NJ 07208
Phone (908) 351-7600

500 Grand Ave
Englewood, NJ 07631
Phone (201) 541-0440

833 Lacey Rd
Forked River, NJ 08731
Phone (609) 242-2334

1043 W Main St
Freehold, NJ 07728
Phone (732) 462-1900

375 US Highway 206
Hillsborough, NJ 08844

210 W Saint Georges Ave
Linden, NJ 07036
Phone (908) 486-1111

2315 Route 34
Ste C
Manasquan, NJ 08736
Phone (732) 974-0404

2130 Millburn Ave
Ste A8
Maplewood, NJ 07040
Phone (732) 383-4166

111 Union Valley Rd
Monroe Twp, NJ 08831
Phone (609) 395-3470

400 W Route 38
Ste 2300
Moorestown, NJ 08057

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

10 Plum St
New Brunswick, NJ 08901
Phone (732) 235-6333

235 Franklin Ave
Nutley, NJ 07110
Phone (973) 235-9090

3822 River Rd
Point Pleasant Boro, NJ 08742
Phone (732) 701-4848

75 Veronica Ave
Somerset, NJ 08873
Phone (732) 246-0060

699 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 836-2500

48 N Gilbert St
Tinton Falls, NJ 07701
Phone (732) 530-5750

Interoperability endpoints

  • Direct secure messaging: mgottesman845662@nychhc.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670112000000",
    "number": "1003203910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2022-12-04",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "NJ",
            "license": "25MA11610900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.