Individual provider Active NPI

Rohit Gautam, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Van Buren, ME
National Provider Identifier
1780994194
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
018786 Issued in ME
Practice address
4 Main St
Van Buren, ME 04785-1009
Phone
(207) 868-2796
Fax
(207) 868-2799
NPI assigned
Oct 19, 2010
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 018786 ME Primary

Addresses

Primary practice location

4 Main St
Van Buren, ME 04785-1009

Mailing address

PO Box 40
Caribou, ME 04736-0040
Phone (207) 498-2359

Other identifiers 1

IdentifierTypeStateIssuer
002435201OtherMEDICARE PTAN

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
I20200225002557 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8527232859 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

55 Medford Ave
Unit E
Patchogue, NY 11772-1229
Phone (631) 689-6698

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018786MEMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Mar 23, 2020 Accepting new patients
CHS Physician Partners, P.C CurrentSince Jan 27, 2021 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Medihealth Medical PC CurrentSince May 25, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Mar 23, 2020 Accepting new patients

Locations

500 Commack Rd
Ste D
Commack, NY 11725

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

200 E Main St
Patchogue, NY 11772
Phone (631) 654-9400

200 E Main St
#P
Patchogue, NY 11772

55 Medford Ave
Unit E
Patchogue, NY 11772
Phone (631) 687-4190

30 Columbia St
Poughkeepsie, NY 12601
Phone (845) 483-5934

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

11112 Liberty Ave
South Richmond Hl, NY 11419
Phone (718) 641-1212

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: rgautam131321@direct-chsli.net

Organizations & group practices 5

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 4

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1780994194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047360040",
            "telephone_number": "207-498-2359",
            "fax_number": "207-498-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MAIN ST",
            "city": "VAN BUREN",
            "state": "ME",
            "postal_code": "047851009",
            "telephone_number": "207-868-2796",
            "fax_number": "207-868-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "ROHIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "ME",
            "license": "018786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "002435201",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, ME

Sources for this page

Verify at the official NPI Registry.