Gail Ettienne, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

112603-01 Issued in NY

Practice address

40 Heyward St
Brooklyn, NY 11249-7823

Phone

(718) 858-6200

NPI assigned

Dec 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Internal Medicine

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• CCN 040784 Hospital, CCN 040784

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Emergency Staffing Solutions Region III

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1689967895

  AR

  Medicare reassignment
• Monticello Ess LLC

  • Emergency Medicine Physician
  • Monticello, AR
  • NPI 1184010753
  Medicare reassignment

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

• Ouachita County Medical Center

  • Rural Acute Care Hospital
  • Camden, AR
  • NPI 1245284769
  Care Compare affiliation

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1063172013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 ROCKAWAY PKWY APT D7",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123112",
            "telephone_number": "929-610-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HEYWARD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112497823",
            "telephone_number": "718-858-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTIENNE",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "112603-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Brooklyn",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "40 Heyward St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112497823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaili Ets, BHSC., MSC.OT
• Etta Novick MD & Isaac M Novick MD PC
• Etta Novick MD & Isaac M Novick MD PC
• Alana M Ettienne Steele
• Cheryl-Ann S Ettienne, ED.D, MS, AGPCNP
• David Jay Ettinger, DPT
• Gitty Ettinger
• Michael Neal Ettinger, DDS
• Reva Leah Ettinger
• Howard Ettlinger, SPECIAL ED

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.