Active NPI
Gary L Gottlieb, MD
- Psychiatry Physician
- Belmont, MA
National Provider Identifier
1821055120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 158371
- Practice address
- McLean Hospital 115 Mill St
Belmont, MA 02478 - Phone
- (617) 732-5537
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 158371 | MA | Primary |
Addresses
Primary practice location
McLean Hospital 115 Mill St
Belmont, MA 02478
Mailing address
1 Huntington Ave Apt 803
Boston, MA 02116-5751
Phone (617) 821-9455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 158371 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1821055120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HUNTINGTON AVE APT 803",
"city": "BOSTON",
"state": "MA",
"postal_code": "021165751",
"telephone_number": "617-821-9455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MCLEAN HOSPITAL 115 MILL ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "02478",
"telephone_number": "617-732-5537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTLIEB",
"first_name": "GARY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2020-10-22",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "158371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.