Individual provider Active NPI

Gary Stephen Gottesman, MD

  • Clinical Genetics (M.D.) Physician
  • Saint Louis, MO
National Provider Identifier
1447269444
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
R6P15 Issued in MO
Practice address
1 Childrens PL
Div Ped Endocrinology and Diabetes
Saint Louis, MO 63110-1002
Phone
(314) 454-6051
Fax
(314) 454-6225
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R6P15 MO
Endocrinology, Diabetes & Metabolism Physician 207RE0101X R6P15 MO
Pediatrics Physician 208000000X R6P15 MO
Clinical Genetics (M.D.) Physician 207SG0201X R6P15 MO Primary

Addresses

Primary practice location

1 Childrens PL
Div Ped Endocrinology and Diabetes
Saint Louis, MO 63110-1002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6051

Other identifiers 1

IdentifierTypeStateIssuer
207929712MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100910000442 MO Practitioner - Medical Genetics and GenomicsPractitioner - Pediatric MedicinePractitioner - Endocrinology 6901921261 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Endocrinology, Pediatric Medicine
Education
University of Michigan Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 273-1006

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R6P15MOMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Jun 1, 2020 Accepting new patients
Shriners Hospitals for Children CurrentSince Jun 1, 2020 Accepting new patients
Washington University CurrentSince Jul 1, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Washington University Past Accepting new patients

Locations

4400 Clayton Ave
Saint Louis, MO 63110
Phone (314) 432-3600

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

5114 Mid America Plz
Ste 3A
Saint Louis, MO 63129
Phone (314) 454-6120

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

660 S Euclid Ave
#8015
Saint Louis, MO 63110
Phone (314) 286-1018

950 W Faris Rd
Greenville, SC 29605
Phone (864) 255-7951

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1447269444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-6051",
            "fax_number": "314-454-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED ENDOCRINOLOGY AND DIABETES",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6051",
            "fax_number": "314-454-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "GARY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-04-17",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R6P15",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "R6P15",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R6P15",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MO",
            "license": "R6P15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207929712",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Endocrinology and Diabetes",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.