Individual provider Active NPI

Gordon H Baltuch, MD

  • Neurological Surgery Physician
  • New York, NY
National Provider Identifier
1932144094
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
312637 Issued in NY
Practice address
710 W 168TH St FL 4
New York, NY 10032-3726
Phone
(212) 305-6092
Fax
(212) 305-2026
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 312637 NY Primary
Neurological Surgery Physician 207T00000X G87701 CA
Neurological Surgery Physician 207T00000X 25MA08687700 NJ
Neurological Surgery Physician 207T00000X MD058514L PA

Addresses

Primary practice location

710 W 168TH St FL 4
New York, NY 10032-3726

Mailing address

710 W 168TH St FL 4
New York, NY 10032-3726
Phone (212) 305-6092

Other identifiers 1

IdentifierTypeStateIssuer
0015989750001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, NY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100311000984 PA Practitioner - Neurosurgery 8325173651 Reassigns benefits to 1 organization
I20110429000405 NJ Practitioner - Neurosurgery 8325173651 Reassigns benefits to 2 organizations
I20211130002280 NY Practitioner - Neurosurgery 8325173651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

500 Grand Ave
Suite 1
Englewood, NJ 07631-4968
Phone (212) 342-8586

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G87701CAMDNeurological Surgery Physician
MD058514LPAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2021 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Neurological Surgery Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Mar 1, 2011 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Mar 1, 2011 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jul 10, 2022 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jul 10, 2022 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2015 Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

710 W 168th St
Fl 4
New York, NY 10032
Phone (212) 304-7190

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 3
Philadelphia, PA 19104

235 S 8th St
Philadelphia, PA 19106
Phone (215) 543-2770

3400 Spruce St
Fl 5
Philadelphia, PA 19104
Phone (215) 662-2777

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 10

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1932144094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-305-6092",
            "fax_number": "215-829-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-305-6092",
            "fax_number": "212-305-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTUCH",
        "first_name": "GORDON",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "312637",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G87701",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA08687700",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD058514L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015989750001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.