Individual provider Active NPI

Constantino Valderrama Gulmatico Jr., M.D.

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1225038375
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
149265 Issued in NY
Practice address
1430 E 29TH St
Brooklyn, NY 11210-5317
Phone
(718) 258-4848
Fax
(718) 258-4851
NPI assigned
Jul 29, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 149265 NY Primary

Addresses

Primary practice location

1430 E 29TH St
Brooklyn, NY 11210-5317

Mailing address

1430 E 29TH St
Brooklyn, NY 11210-5317
Phone (718) 258-4848

Other identifiers 1

IdentifierTypeStateIssuer
00978890MedicaidNY

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
I20110106000798 NY Practitioner - General Surgery 1052500097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulmatico Medical Associates PCGroup PAC ID 2163312703, 2 clinicians

Practice addresses (Care Compare)

3103 Emmons Ave
Brooklyn, NY 11235-1709
Phone (718) 258-4848

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gulmatico Medical Associates, PC CurrentSince Oct 18, 2001 Accepting new patients
Beth Israel Medical Center Past Accepting new patients

Networks

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

Organizations & group practices 2

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 4

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225038375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105317",
            "telephone_number": "718-258-4848",
            "fax_number": "718-258-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105317",
            "telephone_number": "718-258-4848",
            "fax_number": "718-258-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULMATICO",
        "first_name": "CONSTANTINO",
        "middle_name": "VALDERRAMA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "149265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00978890",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.