Frederick Gutman, M.D.

Key facts

NPI

1821026014

Entity type

Individual (NPI type 1)

Primary specialty

Neurological Surgery Physician 207T00000X

License

168176 (NY)

Practice address

24 Research Way Suite 200
New York Spine and Brain Surgery
East Setauket, NY 11733-3487

Phone

(631) 444-1213

Fax

(631) 444-1535

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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.

• New York Spine & Brain Surgery, University Faculty Practice Corporatio Neurological Surgery Physician · Stony Brook, NY · NPI 1154376309
  Medicare reassignment NPD NEUROLOGICAL SURGERY · NY

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles (1 of 5)

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: frederick.gutman@direct.stonybrookmedicine.edu

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 16, 2014.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1821026014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEW YORK SPINE AND BRAIN SURGERY",
            "address_2": "HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948122",
            "telephone_number": "631-444-1213",
            "fax_number": "631-444-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY SUITE 200",
            "address_2": "NEW YORK SPINE AND BRAIN SURGERY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333487",
            "telephone_number": "631-444-1213",
            "fax_number": "631-444-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "168176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01563437",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4517102",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "17J49",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jane Lindsay Gudaitis, PSY.D.
• Michael Guido III, M.D.
• Alexandra Guillaume, MD
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• Tehmina Haque, M.D.
• Mark J Harary, MD
• Harbor View Medical Services PC
• Harbor View Medical Services PC

All providers in East Setauket, NY · Neurological Surgery Physician in New York