Individual provider Active NPI

Gideon Cohen, MD

  • Emergency Medicine Physician
  • Manchester, NH
National Provider Identifier
1336646579
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21208 Issued in NH
Practice address
1 Elliot Way
Manchester, NH 03103-3502
Phone
(603) 669-5300
NPI assigned
Apr 12, 2018
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21208 NH Primary

Addresses

Primary practice location

1 Elliot Way
Manchester, NH 03103-3502

Mailing address

1 Elliot Way
Manchester, NH 03103-3599
Phone (603) 669-5300

Other practice location 1

One Deaconess Road
Rosenberg 2- Attn Nicole McShane
Boston, MA 02215
Phone (617) 754-2339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20210712001385 NH Practitioner - Emergency Medicine 2062814205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

445 Cypress St
Suite 8
Manchester, NH 03103-3600
Phone (603) 552-1670

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services Emergency Medicine CurrentSince Jul 19, 2021 Accepting new patients

Locations

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

1 Elliot Way
Unit 1
Manchester, NH 03103

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.

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1336646579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033599",
            "telephone_number": "603-669-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-669-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Deaconess Road",
            "address_2": "Rosenberg 2- Attn Nicole McShane",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02215",
            "country_code": "US",
            "telephone_number": "617-754-2339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "GIDEON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "21208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.