Jeffrey H. Gottlieb, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

028008 Issued in CT

Practice address

28 Crescent St
Middletown, CT 06457-3654

Phone

(860) 344-6760

Fax

(860) 358-4829

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Boston University School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jgottlieb2389592@direct.trinity-health.org

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.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment Care Compare group NPD
• Harvest Healthcare LLC

  • Clinical Social Worker
  • Avon, CT
  • NPI 1477712917

  Psychiatry

  Medicare reassignment NPD
• Prospect Manchester Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1316394638
  Medicare reassignment NPD
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235
  Medicare reassignment NPD
• Mercy Inpatient Medical Associates Inc.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1407845282
  Medicare reassignment NPD
• Northeast Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment NPD
• Riverbend Medical Group, Inc.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197
  Medicare reassignment NPD
• Uhs of Fuller Inc

  • Psychiatric Hospital
  • S Attleboro, MA
  • NPI 1316917222

  Psychiatry

  Medicare reassignment NPD
• Prospect Rockville Hospital, Inc.

  • General Acute Care Hospital
  • Vernon, CT
  • NPI 1205283538
  Medicare reassignment
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1639135718

  Psychiatry

  NPD
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536
  NPD
• Riverbend Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD

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

• Saint Francis Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Hartford, CT
  • NPI 1144234428
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1407833486
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1871713495
  Care Compare affiliation

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1043292980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-344-6760",
            "fax_number": "860-358-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-344-6760",
            "fax_number": "860-358-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "JEFFREY",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "028008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11280080",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen Goosen, R.PH
• Janet Gordon, MD
• Lucian F Gorgan, MD
• Stacy Gorman, RDH
• Thomas E Gorsky, PA
• Elizabeth Marjorie Gould-Ruitto, RN,C
• Brendon Lewis Graeber, M.D.
• Victoria L Graham, ATC
• Lakisha N Grant-Washington
• Sean Gray, LCSW

• Psychiatry Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.