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DR. VALERIE GAUSMAN M.D.
NPI 1285089797
Internal Medicine - Gastroenterology in New York, NY

Active since May 03, 2016PECOS EnrolledAccepts Medicare Assignment
84.47/100
CMS Quality Rating
550 1ST AVE, NEW YORK, NY 10016(718) 376-1004 Get Directions Write a Review

NPPES record last updated: July 30, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 30, 2024, Apr 4, 2023, Oct 14, 2022 and 2 more (5 updates tracked since 2022).

About Dr. Valerie Gausman M.d. NPPES

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

DR. VALERIE GAUSMAN M.D. (NPI 1285089797) is an individual gastroenterology provider in New York, New York, licensed in New York (294119) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, is affiliated with Morristown Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1285089797
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDR. VALERIE GAUSMANCredential: M.D.
Location Address550 1ST AVENew York, NY 10016-6402
Mailing Address550 1st AveNew York, NY 10016-6402
Phone(718) 376-1004
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMay 3, 2016
Last NPPES UpdateJuly 30, 20245 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1285089797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in NY · 294119✔ Licensed in NJ · 25MA12061500
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
550 1ST AVE, New York, NY 10016
Open in Google Maps ↗

Other Names 1

Former Name (1)Valeriya Dorfman

Secondary Practice Locations 2

Location 133 Overlook Rd Ste 201Summit, NJ 07901-3562 · Phone (908) 522-5040 · Fax (908) 522-5041
Location 2525 Central Ave Ste CWestfield, NJ 07090-2545 · Phone (908) 522-5040 · Fax (908) 522-5041

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Valerie Gausman M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638463961
PECOS Enrollment IDI20240813000626
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 Reassignments

2

Medicare enrollment records show Valerie Gausman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Practice Associates Medical Group
26 mi
Internal Medicine
100 MADISON AVENUE, INTEROFFICE #68
Morristown, NJ 07960
  • Reassigned Medicare billing, New Jersey enrollment
  • 1,699 clinicians in this Medicare group
NPI 1427016385 (844) 264-2250
New York University
1,039 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

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

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
72 services46 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
58 services47 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
50 services50 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
47 services46 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
25 services20 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services23 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310015
Location100 Madison AveMorristown, NJ 07960 · Morris County
Emergency services Birthing friendly

Overlook Medical Center

Acute Care Hospitals · Summit, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310051
Location99 Beauvoir AvenueSummit, NJ 07901 · Union County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.33
Promoting Interoperability100
Improvement Activities40
Cost54.91

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.

DR. SHARON URALIL D.O.
Internal Medicine
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-3293
DR. DIANA TREVAS FLEISHER
Emergency Medicine (Pediatric Emergency Medicine)
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-3293
DR. MONICA GUPTA M.D.
Allergy & Immunology
550 1ST AVE, NBV 16N30, INTERNAL MEDICINE RESIDENCY PROGRAM
NEW YORK, NY 10016
New York County (212) 263-6397
CHRISTINE CHAN M.D.
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506
DR. MATTHEW CHIARELLO MD
Radiology (Vascular & Interventional Radiology)
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506
DR. MEGAN ELIZABETH JENKINS M.D.
Surgery
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-7300
DR. MANAN PATEL M.D.
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506
VICKY CHIANG
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506

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 Valerie Gausman's NPI number?

The NPI number for Valerie Gausman is 1285089797. It was assigned to this individual provider in the NPPES registry on May 3, 2016. The provider is also known as Valeriya Dorfman.

Where is Valerie Gausman located?

Valerie Gausman practices at 550 1st Ave, New York, NY 10016. The listed phone number is (718) 376-1004.

What is Valerie Gausman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Valerie Gausman enrolled in Medicare?

Yes. Valerie Gausman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Valerie Gausman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Valerie Gausman reassigns Medicare benefits to 2 organizations: Practice Associates Medical Group (Morristown, NJ) and New York University (Boynton Beach, FL). Each 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 Valerie Gausman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Valerie Gausman accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Valerie Gausman 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.

Is Valerie Gausman affiliated with any hospitals?

According to CMS data, Valerie Gausman is affiliated with Morristown Medical Center and Overlook Medical Center.

When was this NPI record last updated?

The NPPES record for Valerie Gausman was last updated on July 30, 2024. 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.