Individual provider Active NPI

Eliseo A Go, M.D.

  • Psychiatry Physician
  • Elmhurst, NY
National Provider Identifier
1659466985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
190043 Issued in NY
Practice address
8708 Justice Ave
Suite 1J
Elmhurst, NY 11373-4575
Phone
(917) 476-4952
Fax
(718) 901-6356
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 190043 NY Primary

Addresses

Primary practice location

8708 Justice Ave
Suite 1J
Elmhurst, NY 11373-4575

Mailing address

8708 Justice Ave
Suite 1J
Elmhurst, NY 11373-4575
Phone (917) 476-4952

Other identifiers 2

IdentifierTypeStateIssuer
01640977MedicaidNY
190043OtherNYMEDICAL LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031216000382 NY Practitioner - Psychiatry 8123925385 Reassigns benefits to 1 organization
Practice locations: Elmhurst, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1285 Fulton Ave
Key Extended
Bronx, NY 10456-3401
Phone (718) 992-7669

87 -08 Justice Ave
Suite 1J
Elmhurst, NY 11373-4576

8708 Justice Ave
Apt 1J
Elmhurst, NY 11373-4576
Phone (917) 476-4952

Hospital & facility affiliations

  • Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190043NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Psychiatry CurrentSince Oct 10, 2000 Accepting new patients
Bronxcare Health System CurrentSince Oct 10, 2000 Accepting new patients
Bronxcare Health System Past Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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.

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659466985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "SUITE 1J",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734575",
            "telephone_number": "917-476-4952",
            "fax_number": "718-901-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "SUITE 1J",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734575",
            "telephone_number": "917-476-4952",
            "fax_number": "718-901-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GO",
        "first_name": "ELISEO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "190043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01640977",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "190043",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.