Individual provider Active NPI

Simona Goschin, M.D.

  • Specialist
  • New York, NY
National Provider Identifier
1174754311
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
317 E 17TH St
Suite 5F09
New York, NY 10003-3804
Phone
(212) 420-4352
Fax
(212) 420-4332
NPI assigned
Aug 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

317 E 17TH St
Suite 5F09
New York, NY 10003-3804

Mailing address

317 E 17TH St
Suite 5F09
New York, NY 10003-3804
Phone (212) 420-4352

Other identifiers 1

IdentifierTypeStateIssuer
03869005MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140827002152 NY Practitioner - Psychiatry 6305064643 Reassigns benefits to 3 organizations
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince May 15, 2018 Accepting new patients
Maimonides Medical Center Current Accepting new patients
North Shore - Lij Medical PC CurrentSince May 15, 2018 Accepting new patients
Maimonides Department of Psychiatry FPP CurrentSince Nov 9, 2015 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Nov 9, 2015 Accepting new patients
MMC OB-GYN Faculty Practice Plan Specialist Past Accepting new patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients

Locations

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

111 E 77th St
New York, NY 10075
Phone (212) 434-2810

100 E 77th St
#2
New York, NY 10075
Phone (212) 434-2460

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: sgoschin68207@northwell.direct-ci.com
  • Direct secure messaging: simonagoschin@mai.allscriptsdirect.net

Organizations & group practices 7

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.

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": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1174754311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 17TH ST",
            "address_2": "SUITE 5F09",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-420-4352",
            "fax_number": "212-420-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E 17TH ST",
            "address_2": "SUITE 5F09",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-420-4352",
            "fax_number": "212-420-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSCHIN",
        "first_name": "SIMONA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03869005",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.