Leo J Gosselin Jr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

216822 Issued in NY

Practice address

1571 Washington St
Suite 201
Watertown, NY 13601-9304

Phone

(315) 782-1650

Fax

(315) 788-8547

NPI assigned

Nov 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgosselin@samaritanmedicalpractice.medentdirect.com

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.

• Samaritan Medical Practice, PC

  • Surgery Physician
  • Watertown, NY
  • NPI 1124202619

  NY, Surgery

  Medicare reassignment Care Compare group NPD
• Claxton-Hepburn Medical Center

  • Psychiatric Hospital Unit
  • Ogdensburg, NY
  • NPI 1346301389
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lewis County

  • Rural Acute Care Hospital
  • Lowville, NY
  • NPI 1487689402

  Hospital

  Care Compare affiliation
• Lewis County General Hospital

  • Critical Access Hospital
  • Lowville, NY
  • NPI 1619390838

  Hospital

  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745

  Hospital

  Care Compare affiliation

Specialty

General Surgery

Education

University of Vermont College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Medical Practice PC 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• Lewis County General Hospital Hospital, Lowville, NY, CCN 331317

Procedures performed for Medicare patients

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1124001995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "LEO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "216822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02060373",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bili-Jo Gokey
• Elaina Ruth Gokey, DC
• Christina Gooch
• Lori J Gooding, MSW, MSOM
• David Christopher Gordon, PH.D., M.D.
• Shea N Gould, LPN
• Jessica Lynn Goutremout, MSW INTERN
• Jordon Graban
• Damien Graham, RPH
• Michelle Lee Graham

• All providers in Watertown, NY
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.

Verify at the official NPI Registry.