Active NPI
Nicholas Gavin, M.D.
- Emergency Medicine Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 269056
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A114742 | Other | CA | CALIFORNIA 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
Enrollment records 1
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
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
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A114742 | CA | MD | Emergency Medicine Physician |
| 269056 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fpa Hospital Based | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Emergency Medicine | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Emergency Medicine | Current | Accepting new patients |
| New York University | Emergency Medicine | Current | Accepting new patients |
| Fpa Hospital Based | Emergency Medicine | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Emergency Medicine | Current | Accepting new patients |
| Fpa Hospital Based | Current | 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
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- 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.
-
- Rehabilitation Practitioner
- New York, NY
- NPI 1477899078
-
- Emergency Medicine Physician
- New York, NY
- NPI 1679083984
-
- Nuclear Medicine Physician
- New York, NY
- NPI 1629319413
-
- Emergency Medicine Physician
- New York, NY
- NPI 1124392238
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
Emergency Medicine, NY
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
NY
-
- Emergency Medicine Physician
- New York, NY
- NPI 1427398676
-
- Dermatopathology (Pathology) Physician
- New York, NY
- NPI 1841531795
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Emergency Medicine
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Island City, NY
- NPI 1245248939
-
- Rehabilitation Hospital
- New York, NY
- NPI 1669440327
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- General Acute Care Hospital
- New York, NY
- NPI 1225295512
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.