Bert Walter Gottesman, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

148220 Issued in NY

Practice address

4802 12TH Ave
1B
Brooklyn, NY 11219-3072

Phone

(347) 417-1165

NPI assigned

Nov 14, 2011

Last updated

Jan 28, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1417234774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 12TH AVE",
            "address_2": "1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193072",
            "telephone_number": "347-417-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 12TH AVE",
            "address_2": "1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193072",
            "telephone_number": "347-417-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "BERT",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "148220",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "148220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rivka Gottehrer, MSED
• Yael Gottehrer
• Gottesman Medical PC
• Alexander Michael Gottesman, CRNA
• Avraham J. Gottesman, M.D.
• Brenda Gottesman
• Dana Gottesman, PHD
• David Gottesman, BSN
• Democleia Gottesman, MD
• Ephraim Gottesman

• General Practice Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.