Organization Active NPI

Robert J. Gottlieb, DPM, PC

  • Podiatrist
  • Oyster Bay, NY
National Provider Identifier
1720294101
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N002806 Issued in NY
Legal business name
ROBERT J. GOTTLIEB, DPM, PC
Practice address
188 W Main St
Oyster Bay, NY 11771-2267
Phone
(516) 404-1332
Fax
(516) 922-0289
NPI assigned
May 15, 2007
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Ms. Pamela Beliveau
Title
Office Manager
Phone
(516) 404-1332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N002806 NY Primary

Addresses

Primary practice location

188 W Main St
Oyster Bay, NY 11771-2267

Mailing address

188 W Main St
Oyster Bay, NY 11771-2267
Phone (516) 404-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070928000404 NY Part B Supplier - Clinic/Group Practice 2365537891 Receives reassigned benefits from 3 practitioners
Practice locations: Deer Park, NY; Oyster Bay, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1720294101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 W MAIN ST",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117712267",
            "telephone_number": "516-404-1332",
            "fax_number": "516-922-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 W MAIN ST",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117712267",
            "telephone_number": "516-404-1332",
            "fax_number": "516-922-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. GOTTLIEB, DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "BELIVEAU",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-404-1332",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N002806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oyster Bay, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.