Individual provider Active NPI

Malcolm H Gottesman, MD

  • Specialist
  • East Meadow, NY
National Provider Identifier
1083677389
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
166564 Issued in NY
Practice address
1530 Front St Ste 400
East Meadow, NY 11554-2265
Phone
(516) 324-7500
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 166564 NY Primary

Addresses

Primary practice location

1530 Front St Ste 400
East Meadow, NY 11554-2265

Mailing address

200 Old Country Rd
Suite 370
Mineola, NY 11501-4235

Other practice location 1

200 Old Country Rd
Suite 370
Mineola, NY 11501-4235
Phone (516) 663-4528

Other identifiers 14

IdentifierTypeStateIssuer
108754OtherNYUS FAMILY HEALTHPLAN
OC6883OtherNYHEALTH NET
100806OtherNYUNITED HEALTHCARE
4269008OtherNYAETNA USHC (PPO)
0006491OtherNYGHI (CBP)
1305413OtherNYFIRST HEALTH
AS1190OtherNYOXFORD
0489698OtherNYAETNA USHC(HMO,FAMILY)
166564-5OtherNYWORKER'S COMPENSATION
36E651OtherNYBLUE CHOICE
000000073359OtherNYGHI (HMO)
01110970MedicaidNY
166564OtherNYHIP
6216385003OtherNYCIGNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgottesman230621@nyumc.direct-ci.com

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060304000004 NY Practitioner - Neurology 5890701551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Albany Medical College of Union University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1530 Front St
East Meadow, NY 11554-2265
Phone (516) 324-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166564NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 14, 2018 Accepting new patients
New York University CurrentSince Aug 14, 2018 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients

Locations

1530 Front St
Ste 400
East Meadow, NY 11554
Phone (516) 324-7500

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

200 Old Country Rd
Ste 125
Mineola, NY 11501
Phone (516) 408-4900

200 Old Country Rd
Ste 370
Mineola, NY 11501
Phone (516) 541-0300

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

Networks

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

Interoperability endpoints

  • Direct secure messaging: mgottesman230621@nyumc.direct-ci.com

Organizations & group practices 3

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 7

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083677389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 370",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 FRONT ST STE 400",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542265",
            "telephone_number": "516-324-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Old Country Rd",
            "address_2": "SUITE 370",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115014235",
            "country_code": "US",
            "telephone_number": "516-663-4528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "MALCOLM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2023-03-07",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "166564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US FAMILY HEALTHPLAN",
            "identifier": "108754",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "OC6883",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "100806",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC (PPO)",
            "identifier": "4269008",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI (CBP)",
            "identifier": "0006491",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1305413",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "AS1190",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC(HMO,FAMILY)",
            "identifier": "0489698",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "166564-5",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "36E651",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI (HMO)",
            "identifier": "000000073359",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01110970",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "166564",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6216385003",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgottesman230621@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1530 Front St Ste 400",
            "city": "East Meadow",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115542265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.