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KUSHAL GAUTAM
NPI 1104562438
Student in an Organized Health Care Education/Training Program in Valhalla, NY

Active since May 10, 2022PECOS Enrolled
100 WOODS RD, VALHALLA, NY 10595(570) 866-3058 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 29, 2022, May 25, 2022, May 10, 2022 (3 updates tracked since 2022).

About Kushal Gautam NPPES

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

KUSHAL GAUTAM (NPI 1104562438) is an individual student in an organized health care education/training program in Valhalla, New York and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104562438
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKUSHAL GAUTAM
Location Address100 WOODS RDValhalla, NY 10595-1530
Mailing Address100 Woods RdValhalla, NY 10595-1530 · (914) 493-7000
Phone(570) 866-3058
Sole ProprietorNo
Enumeration DateMay 10, 2022
Last NPPES UpdateApril 21, 20253 updates tracked since enumeration
NPPES CertifiedApril 21, 2025
✔ NPI 1104562438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
100 WOODS RD, Valhalla, NY 10595
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kushal Gautam is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

MRS. LISA ANN SAUER N.P.
Nurse Practitioner (Neonatal, Critical Care)
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-7000
KAREN FRANCOIS MD
Anesthesiology
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-7000
KIMBERLY WILSON R.D.
Dietitian, Registered
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-7664
RADHIKA VOLETI M.D
Internal Medicine
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-7000
FAREENA NAWAZ MD
Internal Medicine
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-7000
AUSTIN B CARPENTER
Student in an Organized Health Care Education/Training Program
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-8795
AMRO AGLAN MD
Student in an Organized Health Care Education/Training Program
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-7000
HAO WANG MD, PHD
Student in an Organized Health Care Education/Training Program
100 WOODS RD
VALHALLA, NY 10595
Westchester County (914) 493-6613

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 Kushal Gautam's NPI number?

The NPI number for Kushal Gautam is 1104562438. It was assigned to this individual provider in the NPPES registry on May 10, 2022.

Where is Kushal Gautam located?

Kushal Gautam practices at 100 Woods Rd, Valhalla, NY 10595. The listed phone number is (570) 866-3058.

What is Kushal Gautam's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kushal Gautam enrolled in Medicare?

Yes. Kushal Gautam is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kushal Gautam was last updated on April 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.