Organization Active NPI

Bare Mountain Medicine PC

  • Physician Assistant
  • Ewing, NJ
National Provider Identifier
1417852278
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
BARE MOUNTAIN MEDICINE PC
Practice address
820 Bear Tavern Rd
Ewing, NJ 08628-1021
Phone
(786) 556-2111
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Authorized official

Name
Yakov Gologorsky, MD
Title
Incorporator
Phone
(973) 707-3048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

820 Bear Tavern Rd
Ewing, NJ 08628-1021

Mailing address

820 Bear Tavern Rd
Ewing, NJ 08628-1021

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1417852278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 BEAR TAVERN RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 BEAR TAVERN RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281021",
            "telephone_number": "786-556-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARE MOUNTAIN MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "GOLOGORSKY",
        "authorized_official_first_name": "YAKOV",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "973-707-3048",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.