Individual provider Active NPI

Robbins L Gottlock, M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1376622662
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
225331 Issued in NY
Practice address
222 W 14TH St
New York, NY 10011-7200
Phone
(212) 604-1800
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 225331 NY Primary

Addresses

Primary practice location

222 W 14TH St
New York, NY 10011-7200

Mailing address

PO Box 95000-2454
Philadelphia, PA 19195-2454
Phone (212) 604-1800

Other identifiers 1

IdentifierTypeStateIssuer
225331OtherNYNYS LICENSE

Other names 1

  • Dr. Jeffrey R Lines Former name

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
I20060118001048 NY Practitioner - Family Practice 0547284473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 366-3000

Hospital & facility affiliations

  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Family Medicine CurrentSince Nov 26, 2018 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

777 N Broadway
Ste 305
Sleepy Hollow, NY 10591
Phone (914) 366-6120

362 N Broadway
Ste 2
Sleepy Hollow, NY 10591
Phone (914) 631-2070

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: rgottlock65465@northwell.direct-ci.com

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 and National Provider Directory roles.

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1376622662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2454",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952454",
            "telephone_number": "212-604-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117200",
            "telephone_number": "212-604-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLOCK",
        "first_name": "ROBBINS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "225331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "225331",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "LINES",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.