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

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: August 16, 2026.

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

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, and ordering and referring status from the CMS PECOS system.

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.

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.

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 2 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.