New York Physician PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

NEW YORK PHYSICIAN PLLC

Practice address

535 5TH Ave FL 4
New York, NY 10017-8020

Phone

(628) 260-5154

Fax

(855) 691-0403

NPI assigned

Aug 7, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Sekuleo Gathers, M.D.NPI 1598842098

Title

Owner

Phone

(888) 970-3777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sekuleo Gathers, MD

  • Family Medicine Physician
  • New York, NY
  • NPI 1598842098
  Medicare reassignment Authorized official
• Victoria L Sully, RN

  • Family Nurse Practitioner
  • Brooklyn, NY
  • NPI 1477824670
  Medicare reassignment NPD
• Dorly M Nerval, MD

  • Internal Medicine Physician
  • Doylestown, PA
  • NPI 1366605230

  NY

  Medicare reassignment NPD
• Adah Obekpa, M.D

  • Internal Medicine Physician
  • New York, NY
  • NPI 1033216387
  NPD (past)

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1669804100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 5TH AVE FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100178020",
            "telephone_number": "888-970-3777",
            "fax_number": "888-970-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 5TH AVE FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100178020",
            "telephone_number": "628-260-5154",
            "fax_number": "855-691-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PHYSICIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "GATHERS",
        "authorized_official_first_name": "SEKULEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-970-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• New York Physical Therapy Service,PC
• New York Physicians LLP
• New York Physicians LLP
• New York Plastic Surgery PC
• New York Plaza Physical Therapy PC
• New York Podiatric Medicine & Surgery PC

• General Practice Physician in New York, NY
• Providers in New York, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.