Organization Active NPI

Elisabeth Gomori MDPC

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1790043164
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
155103 Issued in NY
Legal business name
ELISABETH GOMORI MDPC
Practice address
30 Park Ave
Ste1&2
New York, NY 10016-3801
Phone
(212) 779-1430
Fax
(212) 545-1925
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Dr. Elisabeth Gomori, MDNPI 1790760981
Title
Owner
Phone
(212) 779-1430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 155103 NY Primary

Addresses

Primary practice location

30 Park Ave
Ste1&2
New York, NY 10016-3801

Mailing address

30 Park Ave
Ste1&2
New York, NY 10016-3801
Phone (212) 779-1430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120504000008 NY Part B Supplier - Clinic/Group Practice 2062674229 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

30 Park Ave
Ste 12
New York, NY 10016
Phone (212) 779-1430

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1790043164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "address_2": "STE1&2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163801",
            "telephone_number": "212-779-1430",
            "fax_number": "212-545-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "address_2": "STE1&2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163801",
            "telephone_number": "212-779-1430",
            "fax_number": "212-545-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISABETH GOMORI MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "GOMORI",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-779-1430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "155103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.