Individual provider Active NPI

Nicholas Gavin, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1962702274
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
269056 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 241-6500
NPI assigned
Nov 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A114742 CA
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 269056 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

1761 E 38TH St
Oakland, CA 94602-1655
Phone (732) 887-9603

Other practice location 1

1411 E 31st St
Department of Emergency Medicine
Oakland, CA 94602-1018
Phone (510) 437-4564

Other identifiers 1

IdentifierTypeStateIssuer
A114742OtherCACALIFORNIA MEDICAL BOARD, MEDICAL LICENSE NUMBER

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140414001615 NY Practitioner - Emergency Medicine 1355507534 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians
Icahn School of Medicine at Mount SinaiGroup PAC ID 6103251491, 50 clinicians

Practice addresses (Care Compare)

1468 Madison Ave
New York, NY 10029-6508
Phone (212) 987-3100

234 E 85TH St
New York, NY 10028-3001
Phone (646) 605-5669

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A114742CAMDEmergency Medicine Physician
269056NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 13, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
New York University CurrentSince Jul 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 13, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Trustees of Columbia University in the City of New York Emergency Medicine CurrentSince Jan 13, 2019 Accepting new patients
New York University Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Fpa Hospital Based CurrentSince Apr 15, 2022 Accepting new patients
San Joaquin Emergency Medical Associates Emergency Medicine Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

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

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

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

Networks

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

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 13

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.

View all 13

Hospital & facility affiliations 6

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": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1962702274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 E 38TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021655",
            "telephone_number": "732-887-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 E 31st St",
            "address_2": "Department of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-437-4564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-02",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A114742",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "269056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL BOARD, MEDICAL LICENSE NUMBER",
            "identifier": "A114742",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.