Max W Gottesman, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

OS008331L Issued in PA

Practice address

1910 Sassafras St
Behavioral Health Unit
Erie, PA 16502-2716

Phone

(814) 452-5490

Fax

(814) 452-7610

NPI assigned

Jul 21, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Northwest Beacon Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Erie, PA
  • NPI 1689695868
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548281918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST",
            "address_2": "BEHAVIORAL HEALTH UNIT",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716",
            "telephone_number": "814-452-5490",
            "fax_number": "814-452-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST",
            "address_2": "BEHAVIORAL HEALTH UNIT",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716",
            "telephone_number": "814-452-5490",
            "fax_number": "814-452-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "MAX",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "OS008331L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Eve Gorski, CRNP
• Crystal Goss
• Elizabeth A Gotham, PT
• Zachary Gotham, PA-C
• Cory Gotowka, DO
• Shwetha Gottumukkala
• Animesh Chidanandrao Gour, MD
• Rajesh Govindasamy, M.D.
• Amber Graban
• Chad Michael Grabowski, OTR/L

• Child & Adolescent Psychiatry Physician in Erie, PA
• Providers in Erie, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.