Individual provider Active NPI

Dorit Dorcas Gaedtke, MD

  • Internal Medicine Physician
  • Lake Placid, NY
National Provider Identifier
1740254069
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
191687 Issued in NY
Practice address
1927 Saranac Ave
Suite 100
Lake Placid, NY 12946-1112
Phone
(518) 523-7575
Fax
(518) 523-7577
NPI assigned
Feb 14, 2006
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 191687 NY Primary

Addresses

Primary practice location

1927 Saranac Ave
Suite 100
Lake Placid, NY 12946-1112

Mailing address

1927 Saranac Ave
Suite 100
Lake Placid, NY 12946-1112
Phone (518) 523-7575

Other identifiers 1

IdentifierTypeStateIssuer
01410195MedicaidNY

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
I20100317000065 NY Practitioner - Internal Medicine 6103951157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1927 Saranac Ave
Suite 100
Lake Placid, NY 12946-1113
Phone (518) 523-7575

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191687NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Medical Pediatrics Past Accepting new patients
Mountain Medical Services PastSince Oct 1, 2010 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dorit.gaedtke.2@1798.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1740254069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 SARANAC AVE",
            "address_2": "SUITE 100",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461112",
            "telephone_number": "518-523-7575",
            "fax_number": "518-523-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 SARANAC AVE",
            "address_2": "SUITE 100",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461112",
            "telephone_number": "518-523-7575",
            "fax_number": "518-523-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAEDTKE",
        "first_name": "DORIT",
        "middle_name": "DORCAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "191687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01410195",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, NY

Sources for this page

Verify at the official NPI Registry.