Individual provider Active NPI

Tatiana Gouskova, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1114186376
Registry record updated Mar 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
248236-1 Issued in NY
Practice address
119 W 124TH St
Artc, Starting Point Clinic
New York, NY 10027-4920
Phone
(212) 865-2007
Fax
(212) 865-2472
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 248236-1 NY Primary

Addresses

Primary practice location

119 W 124TH St
Artc, Starting Point Clinic
New York, NY 10027-4920

Mailing address

119 W 124TH St
Artc, Starting Point Clinic
New York, NY 10027-4920
Phone (212) 865-2007

Other identifiers 1

IdentifierTypeStateIssuer
00244606MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248236-1NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331942400000",
    "number": "1114186376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W 124TH ST",
            "address_2": "ARTC, STARTING POINT CLINIC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274920",
            "telephone_number": "212-865-2007",
            "fax_number": "212-865-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 124TH ST",
            "address_2": "ARTC, STARTING POINT CLINIC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274920",
            "telephone_number": "212-865-2007",
            "fax_number": "212-865-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUSKOVA",
        "first_name": "TATIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2012-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "248236-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244606",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.