Andreas Gomoll Orthopaedic, PLLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

ANDREAS GOMOLL ORTHOPAEDIC, PLLC

Practice address

523 E 72ND St
New York, NY 10021-4099

Phone

(212) 606-1775

NPI assigned

Aug 3, 2021

Organization subpart

No

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

Authorized official

Name

Andreas Hans Gomoll, MD

Title

Owner/Physician

Phone

(617) 610-4858

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Adashev

  • Surgical Physician Assistant
  • New York, NY
  • NPI 1609312156
  Medicare reassignment
• Meghan Reed, PA-C

  • Surgical Physician Assistant
  • New York, NY
  • NPI 1982160354
  Medicare reassignment
• David S. Levine, M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • New York, NY
  • NPI 1245348978
  NPD (past)
• Andrew David Pearle, MD

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1427071778
  NPD (past)
• Beth Stein, M.D.

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1467480004
  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1114691268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12204",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117880614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214099",
            "telephone_number": "212-606-1775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Blachley Rd",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069020002",
            "country_code": "US",
            "telephone_number": "212-606-1775",
            "fax_number": "646-797-8484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1133 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106043516",
            "country_code": "US",
            "telephone_number": "212-606-1775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1233 2nd Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656705",
            "country_code": "US",
            "telephone_number": "212-606-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 E 70th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214823",
            "country_code": "US",
            "telephone_number": "212-606-1775",
            "fax_number": "646-797-8484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDREAS GOMOLL ORTHOPAEDIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "GOMOLL",
        "authorized_official_first_name": "ANDREAS",
        "authorized_official_middle_name": "HANS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "617-610-4858",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in New York, NY
• Providers in New York, NY by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.