Individual provider Active NPI

Irving H Gomolin, M.D.,

  • Geriatric Medicine (Internal Medicine) Physician
  • Mineola, NY
National Provider Identifier
1306800636
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
181465 Issued in NY
Practice address
222 Station PLZ N
Suite 518
Mineola, NY 11501-3808
Phone
(516) 663-2588
Fax
(516) 663-4644
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 181465 NY Primary

Addresses

Primary practice location

222 Station PLZ N
Suite 518
Mineola, NY 11501-3808

Mailing address

222 Station PLZ N
Suite 518
Mineola, NY 11501-3808
Phone (516) 663-2588

Other identifiers 1

IdentifierTypeStateIssuer
2208482MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address igomolin230571@nyumc.direct-ci.com

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
I20100729000028 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1254332208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients

Locations

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

222 Station Rd
Ste 518
Mineola, NY 11501
Phone (516) 663-2588

378 Syosset Woodbury Rd
Woodbury, NY 11797
Phone (516) 622-7784

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1306800636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 518",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013808",
            "telephone_number": "516-663-2588",
            "fax_number": "516-663-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 518",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013808",
            "telephone_number": "516-663-2588",
            "fax_number": "516-663-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMOLIN",
        "first_name": "IRVING",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "181465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208482",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "igomolin230571@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 Station Plz N",
            "address_2": "SUITE 518",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.