Individual provider Active NPI

Kevin Jeffrey O'Gorman, MD

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1184120867
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
323501 Issued in NY
Practice address
177 Fort Washington Ave FL 2
New York, NY 10032-3733
Phone
(212) 305-4275
NPI assigned
Apr 2, 2018
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27011 MS
Cardiovascular Disease Physician 207RC0000X 323501 NY Primary

Addresses

Primary practice location

177 Fort Washington Ave FL 2
New York, NY 10032-3733

Mailing address

177 Fort Washington Ave FL 2
New York, NY 10032-3733
Phone (212) 305-4275

Other practice location 1

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-0935

Other practice location 2

1100 Wilford Hall Loop, Bldg 4554
59 MDW/Gme
JBSA Lackland, TX 78236-9908
Phone (210) 916-4536

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
I20240528003283 NY Practitioner - Cardiovascular Disease (Cardiology) 9830433291 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27011MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia/Newyork-Presbyterian Advanced Imaging Inc. CurrentSince May 1, 2025 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 20, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Current Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Apr 20, 2024 Accepting new patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Apr 1, 2026 Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

177 Fort Washington Ave
Fl 2
New York, NY 10032
Phone (212) 305-4275

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

722 W 168th St
New York, NY 10032
Phone (212) 305-6754

1111 Westchester Ave
White Plains, NY 10604
Phone (914) 229-5000

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: zny9002@direct.nyp.org

Organizations & group practices 5

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 5

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1184120867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-305-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-305-4275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-0935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop, Bldg 4554",
            "address_2": "59 MDW/GME",
            "address_purpose": "LOCATION",
            "city": "JBSA Lackland",
            "state": "TX",
            "postal_code": "782369908",
            "country_code": "US",
            "telephone_number": "210-916-4536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'GORMAN",
        "first_name": "KEVIN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "27011",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "323501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.