Individual provider Active NPI

Elliot M Gitlitz, DPM

  • Podiatrist
  • Astoria, NY
National Provider Identifier
1720078413
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003465 Issued in NY
Practice address
3175 23Rd St
Astoria, NY 11106-4134
Phone
(718) 956-2200
Fax
(718) 956-2316
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N003465 NY Primary

Addresses

Primary practice location

3175 23Rd St
Astoria, NY 11106-4134

Mailing address

55 Water St
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

88-06 55th Ave
Elmhurst, NY 11373-4437
Phone (718) 271-9730

Other practice location 2

86-15 Queens Blvd
Elmhurst, NY 11373-4427
Phone (718) 899-6600

Other practice location 3

169-59 137th Ave
Rochdale, NY 11434-4517
Phone (718) 525-5600

Other practice location 4

140-15 Sanford Ave
Flushing, NY 11355-2686
Phone (718) 826-4000

Other identifiers 3

IdentifierTypeStateIssuer
P39163OtherNYEMPIRE BLUE CROSS/BLUE SH
00821958MedicaidNY
57006AOtherNYGHI PROVIDER ID

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
N003465NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoflex Physical Therapy & Rehabilitation, P.C. PastSince May 1, 2006 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1720078413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 23RD ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064134",
            "telephone_number": "718-956-2200",
            "fax_number": "718-956-2316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "88-06 55th Ave",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113734437",
            "country_code": "US",
            "telephone_number": "718-271-9730",
            "fax_number": "718-760-6525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "86-15 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113734427",
            "country_code": "US",
            "telephone_number": "718-899-6600",
            "fax_number": "718-606-3881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169-59 137th Ave",
            "address_purpose": "LOCATION",
            "city": "Rochdale",
            "state": "NY",
            "postal_code": "114344517",
            "country_code": "US",
            "telephone_number": "718-525-5600",
            "fax_number": "718-559-5285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140-15 Sanford Ave",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113552686",
            "country_code": "US",
            "telephone_number": "718-826-4000",
            "fax_number": "718-826-4075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GITLITZ",
        "first_name": "ELLIOT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS/BLUE SH",
            "identifier": "P39163",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00821958",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER ID",
            "identifier": "57006A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.