Individual provider Active NPI

Michael S. Gutkin, MD

  • Physical Medicine & Rehabilitation Physician
  • Hackettstown, NJ
National Provider Identifier
1083695258
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MA07353600 Issued in NJ
Practice address
254B Mountain Ave
Suite 201
Hackettstown, NJ 07840-2413
Phone
(908) 684-5800
Fax
(908) 684-5606
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MA07353600 NJ Primary

Addresses

Primary practice location

254B Mountain Ave
Suite 201
Hackettstown, NJ 07840-2413

Mailing address

254B Mountain Ave
Suite 201
Hackettstown, NJ 07840-2413
Phone (908) 684-5800

Other identifiers 1

IdentifierTypeStateIssuer
9042806MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040817000440 NJ Practitioner - Physical Medicine and Rehabilitation 4587636089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

108 Bilby Rd
Suite 201
Hackettstown, NJ 07840-4174
Phone (908) 684-3005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
89.4
Promoting interoperability
97
Improvement activities
40
Cost
76.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07353600NJMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey Sports Medicine and Orthopedic Center LLC CurrentSince Aug 17, 2009 Accepting new patients
North Jersey Sports Medicine & Orthopedic Center, LLC CurrentSince Aug 17, 2009 Accepting new patients

Locations

218 Ridgedale Ave
Ste 202
Cedar Knolls, NJ 07927

108 Bilby Rd
Ste 201
Hackettstown, NJ 07840
Phone (908) 684-5646

254B Mountain Ave
Ste 201
Hackettstown, NJ 07840
Phone (908) 684-5800

376 Lafayette Rd
Ste 202
Sparta, NJ 07871
Phone (908) 684-2480

Interoperability endpoints

  • Direct secure messaging: mgutkin@orthopedicnj.medentdirect.com

Organizations & group practices 2

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 1

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1083695258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254B MOUNTAIN AVE",
            "address_2": "SUITE 201",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402413",
            "telephone_number": "908-684-5800",
            "fax_number": "908-684-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254B MOUNTAIN AVE",
            "address_2": "SUITE 201",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402413",
            "telephone_number": "908-684-5800",
            "fax_number": "908-684-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTKIN",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA07353600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9042806",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackettstown, NJ

Sources for this page

Verify at the official NPI Registry.