Individual provider Active NPI

Eleanor J Gottesman, MD, MPA

  • Child & Adolescent Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1588672265
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
35051927 Issued in OH
Practice address
2816 E 116TH St
Metrohealth Buckeye Health Center
Cleveland, OH 44120-2111
Phone
(216) 957-4000
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 35051927 OH Primary

Addresses

Primary practice location

2816 E 116TH St
Metrohealth Buckeye Health Center
Cleveland, OH 44120-2111

Mailing address

2816 E 116TH St
Metrohealth Buckeye Health Center
Cleveland, OH 44120-2111
Phone (216) 957-4000

Other identifiers 2

IdentifierTypeStateIssuer
0826888MedicaidOH
3034625100OtherOHBWC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35051927OHMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1588672265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 E 116TH ST",
            "address_2": "METROHEALTH BUCKEYE HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202111",
            "telephone_number": "216-957-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 E 116TH ST",
            "address_2": "METROHEALTH BUCKEYE HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202111",
            "telephone_number": "216-957-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "ELEANOR",
        "middle_name": "J",
        "credential": "MD, MPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35051927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0826888",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "3034625100",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.