NPIMap

Organization Active NPI

Paul N Gotkin & David a Gubernick DPM PA

  • Podiatrist
  • Fort Pierce, FL
National Provider Identifier
1831250240
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PAUL N GOTKIN & DAVID A GUBERNICK DPM PA
Practice address
1090 Virginia Ave
Fort Pierce, FL 34982-3640
Phone
(772) 461-2575
Fax
(772) 461-0419
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Authorized official

Name
Dr. Paul N Gotkin, DPM
Title
President
Phone
(772) 286-9912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1090 Virginia Ave
Fort Pierce, FL 34982-3640

Mailing address

2291 SE Federal Hwy
Stuart, FL 34994-4530
Phone (772) 286-9912

Other identifiers 1

IdentifierTypeStateIssuer
029741100MedicaidFL

Other names 1

  • Treasure Coast Podiatry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000858 FL Part B Supplier - Clinic/Group Practice 8820085905 Receives reassigned benefits from 5 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ft Pierce, FL; Stuart, FL; Port St Lucie, FL; Okeechobee, FL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gotkin Gubernick DPM5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1831250240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944530",
            "telephone_number": "772-286-9912",
            "fax_number": "772-286-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 VIRGINIA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349823640",
            "telephone_number": "772-461-2575",
            "fax_number": "772-461-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL N GOTKIN & DAVID A GUBERNICK DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "GOTKIN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-286-9912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029741100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treasure Coast Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.