Ellis J Gottesfeld, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME 72007 Issued in FL

Practice address

7730 Boynton Beach Blvd
#4
Boynton Beach, FL 33437-6155

Phone

(561) 572-0299

Fax

(561) 572-2596

NPI assigned

Jul 13, 2006

Last updated

Oct 28, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Dermatology

Education

State University of New York Downstate Medical Center, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Beach DermatologyGroup PAC ID 6709864218, 19 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://pbd.mmi.prod.fhir.ema-api.com/fhir/r4/

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.

• PBD&P Inc

  dba Palm Beach Dermatology Inc

  • Dermatopathology Physician
  • West Palm Beach, FL
  • NPI 1689640328

  Dermatology

  Medicare reassignment Care Compare group NPD
• Advancements in Dermatology PL

  • Dermatology Physician
  • Boynton Beach, FL
  • NPI 1972657948
  Authorized official Same address or phone
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surq

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  NPD (past)
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology And Cosmetic Surgery

  • Dermatology Physician
  • Heathrow, FL
  • NPI 1528097284
  NPD (past)
• Water's Edge Dermatology, LLC

  • Clinical Medical Laboratory
  • Palm Beach Gardens, FL
  • NPI 1871542787
  NPD (past)
• Hospitalists Emo, LLC

  dba Inpatient Medical Associates of New Jersey

  • Hospitalist Physician
  • Livingston, NJ
  • NPI 1275575623
  NPD (past)
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1255356119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 BOYNTON BEACH BLVD",
            "address_2": "#4",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376155",
            "telephone_number": "561-572-0299",
            "fax_number": "561-572-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 BOYNTON BEACH BLVD",
            "address_2": "#4",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376155",
            "telephone_number": "561-572-0299",
            "fax_number": "561-572-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESFELD",
        "first_name": "ELLIS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME 72007",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME72007",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME72007",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME72007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harvey Joel Gorfinkel, MD
• Baruch David Gorman, M.D.
• Diana Gorokhovsky, D.O.
• Gospa Medical Group, LLC
• Sarah Gostich, DPM
• Adam Neal Gottlieb
• Elizabeth A Gottlieb, ARNP
• Shara Goudreau, LMHC
• Gould Therapy Inc.
• Cari Danielle Graber Schuk, DO

• Dermatology Physician in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.