Active NPI
Gary I Gorodokin, MD
- Gastroenterology Physician
- Fair Lawn, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 25MA06159800
- Practice address
- 24-07 A Broadway
Fair Lawn, NJ 07410 - Phone
- (201) 791-7760
- Fax
- (201) 791-7746
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 25MA06159800 | NJ | Primary |
| Gastroenterology Physician | 207RG0100X | 182511 | NY |
Addresses
Primary practice location
24-07 A Broadway
Fair Lawn, NJ 07410
Mailing address
5 Toboggan Ridge Rd
Saddle River, NJ 07458-2521
Phone (201) 791-7760
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3V7781 | Other | NJ | EMPIRE |
| 5596271 | Other | NJ | AETNA |
| 2504592 | Other | GHI | |
| 758683 | Other | NY | EMPIRE |
| P698453 | Other | OXFORD | |
| 6878105 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- State University of New York Downstate Medical Center, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748
Phone (201) 224-0011
24 -03 Broadway
Fair Lawn, NJ 07410-3053
Phone (201) 791-7760
277 Quassaick Ave
New Windsor, NY 12553-7632
Phone (845) 565-5630
2829 Ocean Pkwy
Brooklyn, NY 11235-7869
Phone (718) 743-8668
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 95
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 181 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 122 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA06159800 | NJ | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hudson MD Group | Current | Accepting new patients | |
| Oleg Kaim, M.D., P.C. | Past | Accepting new patients | |
| Maga Medical LLC | Gastroenterology | Past | Accepting new patients |
| Vladimir Melamed, M.D, P.C | Past | Accepting new patients | |
| David W. Lee MD PA | Past | Accepting new patients |
Locations
24-07 Broadway
#A
Fair Lawn, NJ 07410
Phone (201) 791-7760
1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011
784 Grand Ave
Ste 201
Ridgefield, NJ 07657
Phone (201) 346-0999
9 Hospital Dr
Ste A22
Toms River, NJ 08755
Phone (973) 429-1300
443 Northfield Ave
West Orange, NJ 07052
Phone (973) 324-0103
Interoperability endpoints
- gastroenterologyconsultants.garygorodokin@133796.advancedmd-direct.com
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Englewood Cliffs, NJ
- NPI 1497301998
-
dba Horizon Family Medical Group
- Family Medicine Physician
- Goshen, NY
- NPI 1063488179
-
- Adult Medicine Physician
- Fort Lee, NJ
- NPI 1932394079
-
- Internal Medicine Physician
- Englewood, NJ
- NPI 1588871966
-
- Internal Medicine Physician
- Englewood, NJ
- NPI 1669701454
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Paramus, NJ
- NPI 1013912633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786320000000",
"number": "1619996774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 TOBOGGAN RIDGE RD",
"city": "SADDLE RIVER",
"state": "NJ",
"postal_code": "074582521",
"telephone_number": "201-791-7760",
"fax_number": "201-791-7746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24-07 A BROADWAY",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "07410",
"telephone_number": "201-791-7760",
"fax_number": "201-791-7746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORODOKIN",
"first_name": "GARY",
"middle_name": "I",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2026-08-10",
"certification_date": "2026-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NJ",
"license": "25MA06159800",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "182511",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "3V7781",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5596271",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "2504592",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "758683",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P698453",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6878105",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fair Lawn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.