Yael Deborah Gottlieb, MD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP20080-0 Issued in NJ

Practice address

30 Westville Ave
Caldwell, NJ 07006-5602

Phone

(973) 228-6866

Fax

(973) 228-4133

NPI assigned

Mar 31, 2009

Last updated

Aug 6, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of New Jersey PCGroup PAC ID 4082754759, 12 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: ygottlieb@advderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dermatology of New Jersey PC

  • Procedural Dermatology Physician
  • Ridgewood, NJ
  • NPI 1225362783
  Medicare reassignment Care Compare group
• Advanced Surgical Center of Bergen County, P.C.

  • Ambulatory Surgical Clinic/Center
  • Ridgewood, NJ
  • NPI 1679966907
  NPD (past)
• Ahkami Dermatology Associates, LLC

  • Dermatology Physician
  • Woodland Park, NJ
  • NPI 1396172292
  NPD (past)
• Ira Gouterman M.D., PA

  dba Ira H. Gouterman M.D., PA

  • Dermatology Physician
  • Caldwell, NJ
  • NPI 1295806123
  NPD (past)

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1497997811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WESTVILLE AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065602",
            "telephone_number": "973-228-6866",
            "fax_number": "973-228-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WESTVILLE AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065602",
            "telephone_number": "973-228-6866",
            "fax_number": "973-228-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "YAEL",
        "middle_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP20080-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Gallagher, OTR
• Toni E Gialanella, DC
• Gohewec Healthcare Providers
• Mindy Ilene Golin, MA
• Ashley Goodman, LPC
• Grace Home Medical, LLC
• Greco Physical Therapy and Wellness Inc
• Gail Gary Green Jr., DMD
• Elizabeth R Greenberg, M.A.
• Heather Lynne Greulich, LPC, LCADC

• Physician Assistant in Caldwell, NJ
• Providers in Caldwell, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.