Gautam J Desai, M.D.
Individual provider Active NPI Internal Medicine Physician · West Long Branch, NJ
NPI 1245242510 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245242510
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MA07111300 (NJ)
- Practice address
- 842 Broadway
West Long Branch, NJ 07764-1503 - Phone
- (732) 222-0180
- Fax
- (732) 222-3990
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Rwjbh Primary Care Services
Practice addresses (Care Compare)
145 Wyckoff Rd
Suite 301
Eatontown, NJ 07724-1887
Phone (848) 208-5250
Hospital & facility affiliations
- Visiting Nurse Association of Central Jersey Home Care and Hospice
- Hackensack Meridian at Home Monmouth County
- Monmouth Medical Center
- Jersey Shore University Medical Center
- Community Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.51 of 100
- Quality
- 84.27
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051013000703 | NJ | Practitioner - Internal Medicine | 6406809136 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA07111300 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rwjbh Primary Care Services | Internal Medicine | Current |
Accepting new patients |
Locations
145 Wyckoff Rd
Ste 301
Eatontown, NJ 07724
Phone (732) 222-0180
300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200
3301 State Route 66
Ste 120
Neptune, NJ 07753
166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300
3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949
766 Shrewsbury Ave
Ste 100
Tinton Falls, NJ 07724
Phone (732) 945-2009
8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MA07111300 | NJ | Yes |
Addresses
Primary practice location
842 Broadway
West Long Branch, NJ 07764-1503
Mailing address
842 Broadway
West Long Branch, NJ 07764-1503
Phone (732) 222-0180
Other providers in West Long Branch, NJ
- Mary L Dalessandro
- Justina Daley
- Robert James Damurjian
- Frank J Daverso Jr.
- Sarah Delzio
- Jilian Detiberiis
- Kenneth Dicarlo
- Jessica L Dickenman
- Joseph Difazio
- Danielle Dirmeitis
All providers in West Long Branch, NJ · Internal Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.