Individual provider Active NPI

Michael Geci-Black, MD

  • Emergency Medicine Physician
  • Goshen, NY
National Provider Identifier
1114057452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
216226 Issued in NY
Practice address
4 Harriman Dr
Goshen, NY 10924-2410
Phone
(845) 294-2170
NPI assigned
Mar 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 216226 NY Primary

Addresses

Primary practice location

4 Harriman Dr
Goshen, NY 10924-2410

Mailing address

448 Pollack Mountain Rd
Cherry Valley, NY 13320-3137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, KY2 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

Enrollment IDStateProvider typePAC IDDetails
I20031201000593 NY Practitioner - Emergency MedicinePractitioner - Internal Medicine 7113822487 Reassigns benefits to 1 organization
I20111014000456 KY Practitioner - Emergency Medicine 7113822487 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216226NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Sep 8, 2014 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 8, 2014 Accepting new patients
South Central Physicians PLLC CurrentSince Apr 2, 2022 Accepting new patients
Lewis and Clark Emergency Physicians P C Emergency Medicine PastSince May 7, 2024 Accepting new patients

Locations

4604 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-5000

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

Interoperability endpoints

  • Direct secure messaging: michael.geci-black.1@6815.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114057452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 POLLACK MOUNTAIN RD",
            "city": "CHERRY VALLEY",
            "state": "NY",
            "postal_code": "133203137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HARRIMAN DR",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242410",
            "telephone_number": "845-294-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GECI-BLACK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "216226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.