Individual provider Active NPI

David Gottesman, BSN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1467176784
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
648332 Issued in NY
Practice address
1369 E 29TH St
Brooklyn, NY 11210-5314
Phone
(718) 909-4102
NPI assigned
Sep 29, 2022
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 648332 NY Primary

Addresses

Primary practice location

1369 E 29TH St
Brooklyn, NY 11210-5314

Mailing address

1369 E 29TH St
Brooklyn, NY 11210-5314
Phone (718) 909-4102

Other practice location 1

672 Parkside Ave Fl 2
Brooklyn, NY 11226-2298
Phone (718) 246-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
648332NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1467176784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105314",
            "telephone_number": "718-909-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105314",
            "telephone_number": "718-909-4102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "672 Parkside Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112262298",
            "country_code": "US",
            "telephone_number": "718-246-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-29",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "648332",
            "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 Jan 24, 2024; 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.