Active NPI
Dimitry Gomberg
- Specialist
- Brooklyn, NY
National Provider Identifier
1457952368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 1312-38 Street
Brooklyn, NY 11218 - Phone
- (718) 686-3700
- NPI assigned
- Nov 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
1312-38 Street
Brooklyn, NY 11218
Mailing address
1312-38 Street
Brooklyn, NY 11218
Phone (718) 686-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Esd PT OT & SLP PLLC | Occupational Therapist | Current | Accepting new patients |
Locations
2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1457952368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312-38 STREET",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11218",
"telephone_number": "718-686-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312-38 STREET",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11218",
"telephone_number": "718-686-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMBERG",
"first_name": "DIMITRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-06",
"last_updated": "2020-12-01",
"certification_date": "2020-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.