Active NPI
Nicole Gothgen, M.D.
- Anesthesiology Physician
- Buffalo, NY
National Provider Identifier
1326278714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 246924
- Practice address
- 1001 Main St # K3502
Buffalo, NY 14203-1009 - Phone
- (716) 323-6570
- Fax
- (716) 323-6658
- NPI assigned
- Jul 20, 2009
- Last updated
- Mar 4, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 246924 | NY | Primary |
Addresses
Primary practice location
1001 Main St # K3502
Buffalo, NY 14203-1009
Mailing address
1001 Main St # K3502
Buffalo, NY 14203-1009
Phone (716) 323-6570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3095 Harlem Rd
Cheektowaga, NY 14225-2500
Phone (716) 323-6570
818 Ellicott St
Buffalo, NY 14203-1021
Phone (716) 323-6570
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246924 | NY | MD | Anesthesiology Physician |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1326278714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 MAIN ST # K3502",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142031009",
"telephone_number": "716-323-6570",
"fax_number": "716-323-6658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 MAIN ST # K3502",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142031009",
"telephone_number": "716-323-6570",
"fax_number": "716-323-6658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTHGEN",
"first_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-20",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "246924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.