Malcolm D Gottlich, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME57439 Issued in FL

Practice address

1075 Mason Ave
Daytona Beach, FL 32117

Phone

(386) 255-4596

Fax

(386) 258-3561

NPI assigned

Jan 10, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Specialty

Orthopedic Surgery

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-County Surgical Specialists LLCGroup PAC ID 1658540505, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Charleston Home health agency, North Charleston, SC, CCN 427005
• Centerwell Home Health Home health agency, North Charleston, SC, CCN 427035
• Roper-St. Francis Home Health Home health agency, Charleston, SC, CCN 427042
• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Colleton Medical Center Hospital, Walterboro, SC, CCN 420030

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: malcolm.gottlich@hca5.eclinicaldirectplus.com

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.

• Tri-County Surgical Specialists LLC

  • Surgery Physician
  • Charleston, SC
  • NPI 1659661544
  Medicare reassignment Care Compare group NPD

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

• Amedisys Home Health of South Carolina LLC

  dba Amedisys Home Health of Charleston

  • Home Health Agency
  • North Charleston, SC
  • NPI 1033177290
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  dba CenterWell Home Health

  • Home Health Agency
  • North Charleston, SC
  • NPI 1285899526
  Care Compare affiliation
• Roper St Francis Ancillary Services

  dba Roper St. Francis Home Health

  • Home Health Agency
  • Ladson, SC
  • NPI 1619947140
  Care Compare affiliation
• Trident Medical Center, LLC

  dba HCA Healthcare Trident Hospital

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation
• Walterboro Community Hospital, Inc.

  dba HCA Healthcare Colleton Hospital

  • General Acute Care Hospital
  • Walterboro, SC
  • NPI 1376597997
  Care Compare affiliation

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1639158538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLICH",
        "first_name": "MALCOLM",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME57439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007653200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kadie Adah-Ann Goodwin
• Krishnan - Gopal, M.D.
• Virginia Ragsdale Gora, M.A., CCC/SLP
• Deanna Dawn Goracke, MSW
• Gayle Ruth Gordon, LICENSED PRACTICAL N
• Maulik Govani, M.D.
• Luz Elenia Goyco Ortiz, MD
• Emad Sabry Shafiek Grace, M.D
• Fady S Grace, MD
• Graceful Living Alf and Memory Care

• Orthopaedic Surgery Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.

Verify at the official NPI Registry.