NPIMap

Organization Active NPI

Middletown Medical PC

  • Emergency Medicine Physician
  • Middletown, NY
National Provider Identifier
1902855828
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MIDDLETOWN MEDICAL PC
Practice address
111 Maltese Dr
Middletown, NY 10940-2115
Phone
(845) 342-4774
Fax
(845) 818-7555
NPI assigned
May 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Rajan Gulati, MDNPI 1275534000
Title
Ceo
Phone
(845) 342-4774

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 14

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X

Addresses

Primary practice location

111 Maltese Dr
Middletown, NY 10940-2115

Mailing address

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Other identifiers 1

IdentifierTypeStateIssuer
00884280MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070208000144 NY Part B Supplier - Clinic/Group Practice 2567464308 Receives reassigned benefits from 306 practitioners
Practice locations: Middletown, NY; Montgomery, NY; Monticello, NY; Newburgh, NY; Pine Bush, NY; Port Jervis, NY; Warwick, NY; Wurtsboro, NY…
O20140922002275 NY DME Supplier - Physician - General Practice 2567464308 Practice locations: Middletown, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

3452 State Route 97
Barryville, NY 12719
Phone (845) 557-6411

2142 Route 302
Circleville, NY 10919
Phone (845) 888-2200

112 Tops Market Blvd
#209
Ellenville, NY 12428
Phone (845) 647-6700

111 Sullivan Ave
Ferndale, NY 12734
Phone (845) 292-3455

60 Dunning Rd
Middletown, NY 10940
Phone (845) 344-4477

419 E Main St
Ste 307
Middletown, NY 10940
Phone (845) 344-5455

419 E Main St
Ste 309
Middletown, NY 10940

20 Walnut St
Ste A
Montgomery, NY 12549
Phone (845) 457-3979

4058 State Route 42
Ste 5
Monticello, NY 12701

32 Thompson Square Mall
Monticello, NY 12701

193 S Plank Rd
#3
Newburgh, NY 12550
Phone (845) 562-3020

100 Pike St
Port Jervis, NY 12771
Phone (845) 856-5396

209 New Ball St
Port Jervis, NY 12771
Phone (845) 557-6411

1522 State Route 17B
Side B
White Lake, NY 12786

Practitioners & affiliated clinicians

Practitioners 313

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

View all 313

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1902855828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774",
            "fax_number": "845-818-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774",
            "fax_number": "845-818-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-07-05",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "GULATI",
        "authorized_official_first_name": "RAJAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-342-4774",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00884280",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.