Raphael David Gildengorn, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

333345 Issued in NY

Practice address

74 Wallabout St
Brooklyn, NY 11249-7830

Phone

(718) 260-4600

NPI assigned

Apr 26, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: rgildengorn499296@nyumc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oda Primary Health Care Network, Inc.

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1720177066
  NPD (past)

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1639813694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14704 75TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672932",
            "telephone_number": "347-419-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 WALLABOUT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112497830",
            "telephone_number": "718-260-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDENGORN",
        "first_name": "RAPHAEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "333345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Diane Gilberti, OTR/L
• Ella Gilboa, RDN
• Michael Thomas Gilbride, MA MS ADV CERT
• Olga Gilburd, RN
• Gilda Fernandez Nafarrete,MD,PC
• Lawrence Gile, L.M.S.W.
• Abumael Gileau
• Shunda Heddy Giles-Foster
• Katarzyna Izabela Gilewicz, DDS, MS, FICOI
• Casey Gilfillan

• Pediatrics Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.