Individual provider Active NPI

Gary I Gorodokin, MD

  • Gastroenterology Physician
  • Fair Lawn, NJ
National Provider Identifier
1619996774
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA06159800 Issued in NJ
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

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3V7781OtherNJEMPIRE
5596271OtherNJAETNA
2504592OtherGHI
758683OtherNYEMPIRE
P698453OtherOXFORD
6878105MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040719000503 NY Practitioner - Gastroenterology 0840279287 Reassigns benefits to 2 organizations
I20090313000206 NJ Practitioner - GastroenterologyPractitioner - Infectious Disease 0840279287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Infectious Disease
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
Hudson MD GroupGroup PAC ID 6103240478, 110 clinicians
Gastroenterology Consultants of North Jersey PCGroup PAC ID 4880750066, 3 clinicians
Horizon Medical Group PCGroup PAC ID 6103715529, 78 clinicians

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 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy181
Upper gastrointestinal (GI) endoscopy for acid reflux122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA06159800NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson MD Group CurrentSince Jun 7, 2023 Accepting new patients
Oleg Kaim, M.D., P.C. PastSince Dec 15, 1995 Accepting new patients
Maga Medical LLC Gastroenterology Past Accepting new patients
Vladimir Melamed, M.D, P.C PastSince Feb 11, 2013 Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.