Individual provider Active NPI

Moti Gulersen, MD, MSC

  • Maternal & Fetal Medicine Physician
  • New York, NY
National Provider Identifier
1336524859
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
MD476911 Issued in PA
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-2760
NPI assigned
Jul 26, 2015
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 25MA11703200 NJ
Maternal & Fetal Medicine Physician 207VM0101X MD476911 PA Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

333 E 79TH St
Apt. 5U
New York, NY 10075-0956
Phone (929) 429-9680

Other practice location 1

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 875-1209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230125002836 NJ Practitioner - Obstetrics/Gynecology 3678819679 Reassigns benefits to 1 organization
I20230911003822 PA Practitioner - Obstetrics/Gynecology 3678819679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Toronto, Faculty of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Market St
FL 19
Philadelphia, PA 19107-2926

111 S 11TH St
Philadelphia, PA 19107-4824

33 S 9TH Street 3Rd Floor
Jefferson Rehabilitation Medicine
Philadelphia, PA 19107-4414
Phone (215) 955-7190

833 Chestnut St
Suite 138
Philadelphia, PA 19107-4414
Phone (888) 855-6649

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11703200NJMDMaternal & Fetal Medicine Physician
MD476911PAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jul 30, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Feb 1, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. Current Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Feb 1, 2023 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Jefferson Radiation Oncology, LLC Past Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

205 E Laurel Rd
Stratford, NJ 08084
Phone (856) 344-7360

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-5000

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 6

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 1

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": "1437868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1336524859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 79TH ST",
            "address_2": "APT. 5U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750956",
            "telephone_number": "929-429-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Hurffville Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122453",
            "country_code": "US",
            "telephone_number": "856-875-1209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULERSEN",
        "first_name": "MOTI",
        "credential": "MD, MSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-26",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "25MA11703200",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "PA",
            "license": "MD476911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.