Active NPI
Marc David Gottlieb, M.D.
- Otolaryngology Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 196622
- Practice address
- 6740 4TH Ave FL 3
Brooklyn, NY 11220-5350 - Phone
- (929) 455-2700
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 196622 | NY | Primary |
Addresses
Primary practice location
6740 4TH Ave FL 3
Brooklyn, NY 11220-5350
Mailing address
121 Dekalb Ave
Ste 9E Maynard BLDG
Brooklyn, NY 11201-5425
Phone (718) 250-8520
Other practice location 1
121 Dekalb Ave
Ste 9E Maynard BLDG
Brooklyn, NY 11201-5425
Phone (718) 250-8520
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01888499 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgottlieb273299@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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923
150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000
530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
9777 Queens Blvd
Rego Park, NY 11374-3335
Phone (718) 261-9100
Hospital & facility affiliations
- NYU Langone Hospitals
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 196622 | NY | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NYU Langone Hospitals | Current | Accepting new patients | |
| Jamaica Hospital | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| TJH Medical Services, P.C. | Otolaryngology | Current | Accepting new patients |
| New York University | Otolaryngology | Current | Accepting new patients |
| NYU Langone Hospitals | Current | Accepting new patients | |
| NYU Langone Hospitals | Current | Accepting new patients | |
| Jamaica Hospital | Current | Accepting new patients | |
| NYU Langone Hospitals | Past | Accepting new patients | |
| L&L Cervantes Medical PC | Past | Accepting new patients |
Locations
121 DeKalb Ave
Ste 9E
Brooklyn, NY 11201
Phone (718) 250-8520
6740 4th Ave
Fl 3
Brooklyn, NY 11220
Phone (929) 455-2000
121 DeKalb Ave
#9E
Brooklyn, NY 11201
Phone (718) 250-8520
150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185
121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604
11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839
301 E 17th St
New York, NY 10003
Phone (212) 460-0125
9777 Queens Blvd
Rego Park, NY 11374
Phone (718) 275-9300
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088
70 E Sunrise Hwy
Valley Stream, NY 11581
Phone (516) 825-3600
70 E Sunrise Hwy
Fl 5
Valley Stream, NY 11581
Phone (516) 825-3600
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- mgottlieb676173@nychhc.direct-ci.com
Organizations & group practices 10
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.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY, Otolaryngology
-
- Emergency Medical Services (Emergency Medicine) Physician
- Jamaica, NY
- NPI 1477505220
-
- Internal Medicine Physician
- New York, NY
- NPI 1790975944
-
- Skilled Nursing Facility
- Jamaica, NY
- NPI 1750516795
-
- Psychiatric Hospital Unit
- Patchogue, NY
- NPI 1508687021
-
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1831549559
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Specialist
- Woodside, NY
- NPI 1518102987
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1104803287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 DEKALB AVE",
"address_2": "STE 9E MAYNARD BLDG",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015425",
"telephone_number": "718-250-8520",
"fax_number": "718-250-6327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6740 4TH AVE FL 3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112205350",
"telephone_number": "929-455-2700"
}
],
"practiceLocations": [
{
"address_1": "121 Dekalb Ave",
"address_2": "STE 9E MAYNARD BLDG",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112015425",
"country_code": "US",
"telephone_number": "718-250-8520",
"fax_number": "718-250-6327",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOTTLIEB",
"first_name": "MARC",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2021-04-01",
"certification_date": "2021-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NY",
"license": "196622",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01888499",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mgottlieb273299@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "6740 4th Ave Fl 3",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112205350",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.