MICHAEL S GOTTLIEB F.N.P-BC(ANCC) M.S.N
NPI 1215462205
Nurse Practitioner in Ronkonkoma, NY

Q: What is Michael Gottlieb's NPI number?

The NPI number for Michael Gottlieb is 1215462205. It was assigned to this individual provider in the NPPES registry on April 27, 2017.

Q: What is Michael Gottlieb's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Gottlieb was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since April 27, 2017PECOS Enrolled

500 PECONIC ST, 92A, RONKONKOMA, NY 11779(631) 833-0696(206) 350-1094 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 23, 2023, Apr 27, 2017 (2 updates tracked since 2017).

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About Michael S Gottlieb F.n.p-bc(ancc) M.s.n NPPES

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

MICHAEL S GOTTLIEB F.N.P-BC(ANCC) M.S.N (NPI 1215462205) is an individual nurse practitioner in Ronkonkoma, New York, licensed in New York (F-341691) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1215462205

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameMICHAEL S GOTTLIEBCredential: F.N.P-BC(ANCC) M.S.N

Location Address500 PECONIC ST, 92ARonkonkoma, NY 11779-7100

Mailing Address500 Peconic St, 92aRonkonkoma, NY 11779-7100 · (929) 430-7907

Phone(631) 833-0696

Fax(206) 350-1094

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateApril 27, 2017

Last NPPES UpdateOctober 23, 20232 updates tracked since enumeration

NPPES CertifiedOctober 23, 2023

✔ NPI 1215462205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NY · F-341691

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

500 PECONIC ST, Ronkonkoma, NY 11779

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael S Gottlieb F.n.p-bc(ancc) M.s.n is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456626894

PECOS Enrollment IDI20260123003543

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.

Medicare Billing Reassignment

Medicare enrollment records show Michael Gottlieb reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Care Health Network LLC

805 mi

Nurse Practitioner

424 CHURCH ST STE 220
Nashville, TN 37219

Reassigned Medicare billing, Florida enrollment
85 clinicians in this Medicare group

NPI 1619368842 (877) 564-3627

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11779 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

DANIELLE PRUGAR

Genetic Counselor, MS

500 PECONIC ST, APT 317A
RONKONKOMA, NY 11779

Suffolk County (631) 816-0936

DIANE LYNN BARRICELLE COTA

Occupational Therapy Assistant

500 PECONIC ST, APT 1-7B
RONKONKOMA, NY 11779

Suffolk County (631) 846-7555

BONNIE LINNICK M.ED

Behavior Technician

500 PECONIC ST, APT 195A
RONKONKOMA, NY 11779

Suffolk County (631) 295-6333

MS. LISA RAE O'BRIEN LPN

Licensed Practical Nurse

500 PECONIC ST, APT 86A
RONKONKOMA, NY 11779

Suffolk County (917) 543-2311

BELKIS DURAN

Case Manager/Care Coordinator

500 PECONIC ST, APT 96A
RONKONKOMA, NY 11779

Suffolk County (516) 356-4019

MISS CINDI J TIMMERMANN MSW

Social Worker

500 PECONIC ST, APT 5-1B
RONKONKOMA, NY 11779

Suffolk County (631) 676-5974

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 Michael Gottlieb's NPI number?

The NPI number for Michael Gottlieb is 1215462205. It was assigned to this individual provider in the NPPES registry on April 27, 2017.

Where is Michael Gottlieb located?

Michael Gottlieb practices at 500 Peconic St 92A, Ronkonkoma, NY 11779. The listed phone number is (631) 833-0696.

What is Michael Gottlieb's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Michael Gottlieb enrolled in Medicare?

Yes. Michael Gottlieb is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Michael Gottlieb's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Gottlieb reassigns Medicare benefits to Community Care Health Network LLC (Nashville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Gottlieb's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michael Gottlieb was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.