Individual provider Active NPI

Michael Gutkin, M.D.

  • Nephrology Physician
  • Livingston, NJ
National Provider Identifier
1033152244
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MA020352 Issued in NJ
Practice address
349 E Northfield Rd
Suite 202
Livingston, NJ 07039-4802
Phone
(973) 597-1107
Fax
(973) 597-1407
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA020352 NJ Primary

Addresses

Primary practice location

349 E Northfield Rd
Suite 202
Livingston, NJ 07039-4802

Mailing address

349 E Northfield Rd
Suite 202
Livingston, NJ 07039-4802
Phone (973) 597-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA020352NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14016/brand/1/csg/1/fhir/r4

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1033152244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 E NORTHFIELD RD",
            "address_2": "SUITE 202",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394802",
            "telephone_number": "973-597-1107",
            "fax_number": "973-597-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 E NORTHFIELD RD",
            "address_2": "SUITE 202",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394802",
            "telephone_number": "973-597-1107",
            "fax_number": "973-597-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTKIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA020352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.