NPIMap

Organization Active NPI

Paul N Gotkin & David a Gubernick DPM PA

  • Podiatrist
  • Stuart, FL
National Provider Identifier
1477539856
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PAUL N GOTKIN & DAVID A GUBERNICK DPM PA
Practice address
2291 SE Federal Hwy
Stuart, FL 34994-4530
Phone
(772) 286-9912
Fax
(772) 286-2405
NPI assigned
Dec 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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

Authorized official

Name
Dr. Paul N Gotkin, DPMNPI 1861478257
Title
President
Phone
(772) 286-9912

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

2291 SE Federal Hwy
Stuart, FL 34994-4530

Mailing address

2291 SE Federal Hwy
Stuart, FL 34994-4530
Phone (772) 286-9912

Other names 1

  • Treasure Coast Podiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040429000858 FL Part B Supplier - Clinic/Group Practice 8820085905 Receives reassigned benefits from 5 practitioners
3 other NPIs on this enrollment
Practice locations: Ft Pierce, FL; Stuart, FL; Port St Lucie, FL; Okeechobee, FL
O20100930040883 FL DME Supplier - Physician - Podiatry 8820085905 Practice locations: Stuart, FL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gotkin Gubernick DPM5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1090 Virginia Ave
Fort Pierce, FL 34982
Phone (772) 461-2575

1924 US Highway 441 N
Okeechobee, FL 34972
Phone (863) 357-0540

1924 US Highway 441 N
#101
Okeechobee, FL 34972

1924 US Highway 441 N
Ste 101
Okeechobee, FL 34972

1095 NW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 785-5500

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/-c6Xwd-UlrvkHnaNj_A8a39Pa03efHEX/

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272585600000",
    "number": "1477539856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944530",
            "telephone_number": "772-286-9912",
            "fax_number": "772-286-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944530",
            "telephone_number": "772-286-9912",
            "fax_number": "772-286-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL N GOTKIN & DAVID A GUBERNICK DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2010-04-30",
        "status": "A",
        "authorized_official_last_name": "GOTKIN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-286-9912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treasure Coast Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; 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.

Verify at the official NPI Registry.