Individual provider Active NPI

Joseph Eric Gootenberg, M.D.

  • Pediatric Hematology & Oncology Physician
  • Rockville, MD
National Provider Identifier
1629209200
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
D0027242 Issued in MD
Practice address
6915 Breezewood Ter
Rockville, MD 20852-4323
Phone
(301) 881-0818
Fax
(301) 881-0819
NPI assigned
Jul 30, 2009
Last updated
Jul 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0027242 MD
Pediatric Hematology & Oncology Physician 2080P0207X D0027242 MD Primary

Addresses

Primary practice location

6915 Breezewood Ter
Rockville, MD 20852-4323

Mailing address

6915 Breezewood Ter
Rockville, MD 20852-4323
Phone (301) 881-0818

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0027242MDMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1629209200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 BREEZEWOOD TER",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524323",
            "telephone_number": "301-881-0818",
            "fax_number": "301-881-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 BREEZEWOOD TER",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524323",
            "telephone_number": "301-881-0818",
            "fax_number": "301-881-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOTENBERG",
        "first_name": "JOSEPH",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0027242",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MD",
            "license": "D0027242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.