Individual provider Active NPI

Gohar Harutyunyan Tiratsuyan, MD

  • Internal Medicine Physician
  • Bergenfield, NJ
National Provider Identifier
1114690005
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12291800 Issued in NJ
Practice address
1 N Washington Ave
Bergenfield, NJ 07621-2125
Phone
(201) 374-9201
NPI assigned
Jul 27, 2021
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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 25MA12291800 NJ Primary

Addresses

Primary practice location

1 N Washington Ave
Bergenfield, NJ 07621-2125

Mailing address

20 Burling LN
New Rochelle, NY 10801-5664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20241002000710 NJ Practitioner - Internal Medicine 7012448053 Reassigns benefits to 1 organization
I20250701002112 NY Practitioner - Internal Medicine 7012448053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

1 Theall Rd
Rye, NY 10580-1404
Phone (914) 848-8888

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Group, P.C. Internal Medicine CurrentSince Jul 10, 2025 Accepting new patients
The Westchester Medical Group PC CurrentSince Jul 10, 2025 Accepting new patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients

Locations

1 N Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-7333

1555 Center Ave
Ste 2
Fort Lee, NJ 07024
Phone (201) 242-1600

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

1 Theall Rd
Rye, NY 10580
Phone (914) 848-8700

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

Networks

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

Interoperability endpoints

  • Direct secure messaging: gohar.tiratsuyan.1@21260.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1114690005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BURLING LN",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212125",
            "telephone_number": "201-374-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRATSUYAN",
        "first_name": "GOHAR",
        "middle_name": "HARUTYUNYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12291800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergenfield, NJ

Sources for this page

Verify at the official NPI Registry.