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GOTHAM PHARMACY INC
NPI 1093050445
Pharmacy - Community/Retail Pharmacy in New York, NY

Active since December 11, 2012
2258 3RD AVE, (CORNER OF E 123RD ST AND 3RD AVE), NEW YORK, NY 10035(212) 289-7800(212) 289-7806 Get Directions Write a Review

NPPES record last updated: September 23, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gotham Pharmacy Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOTHAM PHARMACY INC (NPI 1093050445) is a healthcare organization registered as a community/retail pharmacy in New York, New York and active in the NPI registry since December 2012. The organization lists Betty Grullon, President, as its authorized official.

NPPES Registry Identity

NPI1093050445
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameGOTHAM PHARMACY INC
Location Address2258 3RD AVE, (CORNER OF E 123RD ST AND 3RD AVE)New York, NY 10035-2208
Mailing Address2258 3rd Ave, (corner Of E 123rd St And 3rd Ave)New York, NY 10035-2208 · (212) 289-7800 · Fax (212) 289-7806
Phone(212) 289-7800
Fax(212) 289-7806
Organization SubpartNo
Authorized OfficialBetty GrullonPresident · (347) 739-2840
Enumeration DateDecember 11, 2012
Last NPPES UpdateSeptember 23, 2013
✔ NPI 1093050445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
2258 3RD AVE, New York, NY 10035
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Other Identifiers 1

Medicare NSC6759900001NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gotham Pharmacy Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20130614000205DME · PharmacyDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Gotham Pharmacy Inc carries, from the Medicare DMEPOS supplier directory.

Gotham Pharmacy Inc

DMEPOS supplier · New York, NY
✔

Accepts Medicare assignment

Gotham Pharmacy Inc agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20346089
Medicare Participant SinceDecember 10, 2022
Supplier Location2258 3rd AveNew York, NY 10035
Phone(212) 289-7800
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HIN WONG
Pharmacist
2258 3RD AVE
NEW YORK, NY 10035
New York County (212) 289-7310
MR. SANJAY PATEL
Pharmacist
2258 3RD AVE
NEW YORK, NY 10035
New York County (212) 289-7807
MR. LYNN YOUNG PHARM D
Pharmacist
2258 3RD AVE
NEW YORK, NY 10035
New York County (212) 289-7310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gotham Pharmacy Inc's NPI number?

The NPI number for Gotham Pharmacy Inc is 1093050445. It was assigned to this organization in the NPPES registry on December 11, 2012.

Where is Gotham Pharmacy Inc located?

Gotham Pharmacy Inc is located at 2258 3rd Ave (corner Of E 123rd St And 3rd Ave), New York, NY 10035. The listed phone number is (212) 289-7800.

What is Gotham Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Gotham Pharmacy Inc enrolled in Medicare?

Yes. Gotham Pharmacy Inc is registered in the Medicare PECOS enrollment system.

When is Gotham Pharmacy Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (New York, Pharmacy) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Gotham Pharmacy Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Gotham Pharmacy Inc accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Gotham Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 39 other insurers list Gotham Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gotham Pharmacy Inc was last updated on September 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.