Individual provider Active NPI

Robert J Gottlieb, DPM

  • Podiatrist
  • Oyster Bay, NY
National Provider Identifier
1922002716
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N002806 Issued in NY
Practice address
188 W Main St
Oyster Bay, NY 11771-2229
Phone
(516) 922-0502
Fax
(516) 922-0289
NPI assigned
Jun 9, 2005
Reactivated
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N002806 NY Primary

Addresses

Primary practice location

188 W Main St
Oyster Bay, NY 11771-2229

Mailing address

188 W Main St
Oyster Bay, NY 11771-2229
Phone (516) 922-0502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070815000196 NY Practitioner - Podiatry 5496847899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

188 W Main St
Oyster Bay, NY 11771-2267
Phone (516) 922-0502

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue151
Removal of skin lesions84
Removal of nail tissue771
Removal or shaving of skin growth304
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N002806NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J. Gottlieb, DPM, PC Podiatrist CurrentSince Jan 1, 1984 Accepting new patients
Robert J. Gottlieb, DPM, PC Podiatrist Past Accepting new patients
Robert J. Gottlieb, DPM, PC Past Accepting new patients

Locations

283 Commack Rd
Commack, NY 11725
Phone (631) 462-2980

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFBHDD/Endpoint/IFBHDD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1922002716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 W MAIN ST",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117712229",
            "telephone_number": "516-922-0502",
            "fax_number": "516-922-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 W MAIN ST",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117712229",
            "telephone_number": "516-922-0502",
            "fax_number": "516-922-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N002806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oyster Bay, NY

Sources for this page

Verify at the official NPI Registry.