GAUTAM T DESAI (NPI# 1639116742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639116742 |
| Entity Type | Individual |
| Full Name | GAUTAM T DESAI |
| Credential | MD |
| Practice Address |
447 Rt 10 Suite 2 Randolph NJ 07869 |
| Mailing Address |
447 Route 10 Suite 2 Randolph NJ 07869 |
| Practice Telephone | 9733614555 |
| Practice Fax Number | 9733616360 |
| Mailing Telephone | 9733614555 |
| Mailing Fax Number | 9733616360 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207R00000X | Internal Medicine | 25MA03468300 | NJ | Allopathic & Osteopathic Physicians |
| X | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
25MA03468300 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 2982803 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245242510 | Gautam J Desai | Internal Medicine | 842 Broadway, West Long Branch, NJ 07764-1503 | 2006-08-13 |
| 1417047663 | Gautam D Desai | Family Medicine | 2020 S Independence Blvd, Suite #3, Virginia Beach, VA 23453 | 2006-10-16 |
| 1881633071 | Gautam Desai | Family Medicine | 1010 Carondelet Dr, Suite #220, Kansas City, MO 64114-4859 | 2006-06-05 |
| Street Address |
447 RT 10 SUITE 2 |
| City | RANDOLPH |
| State | NJ |
| Zip Code | 07869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699398149 | Jaclyn Philbin | Dietitian, Registered | 11 Middlebury Boulevard, Suite 9/10, Randolph, NJ 07869 | 2020-05-19 |
| 1548806896 | Daniel Patrick Walsh | Physical Therapist | 390 Route Nj 10, Suite 202, Randolph, NJ 07869 | 2019-11-21 |
| 1518516061 | New Jersey Center for Cognitive and Dialectical Behavior Therapy | Clinic/Center | 1250 Sussex Tpke Ste N, Randolph, NJ 07869 | 2019-09-07 |
| 1396306031 | Marilyn (lynn) G Teale | Specialist/Technologist | 1248 Sussex Tpk, Unit B11, Randolph, NJ 07869 | 2019-06-24 |
| 1497218580 | Christopher Lamorte | Dentist | 390 Nj-10 West, Randolph, NJ 07869 | 2019-04-07 |
| 1982101309 | Essex County Weightloss, LLC | Family Medicine | 81 State Road 10 East, Randolph, NJ 07869 | 2018-04-11 |
| 1699285569 | Raechel Jean Lofaro | Nurse Practitioner | 8 Chestnut Hil Road, Randolph, NJ 07869 | 2017-10-05 |
| 1851800114 | Stephanie Jasinski | Counselor | 19 Harmony Rd, Randolph, NJ 07869 | 2017-09-29 |
| 1144739244 | Dickerson Dental Group, LLC | Dentist | 714 Route 10, Randolph, NJ 07869 | 2017-09-21 |
| 1053831479 | Melissa Morgan | Pediatrics | College Plaza Pediatrics, 765 Route 10 East, Ste 203, Randolph, NJ 07869 | 2017-06-27 |
| Find all providers in zip 07869 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497929673 | Pallavi Devendra Shah | Internal Medicine | 165 Morris Tpke, Randolph, NJ 07869-2807 | 2008-04-17 |
| 1215113311 | Michael Paul Tillem | Internal Medicine | 70 Wilkeshire Blvd, Randolph, NJ 07869-2041 | 2008-01-18 |
| 1790984268 | Randolph Medical Associates, PC | Internal Medicine | 32 So Main St, Suite 200, Randolph, MA 02368 | 2007-07-16 |
| 1629114129 | Morris Primary Carepc | Internal Medicine | 540 Route 10 West, Randolph, NJ 07869 | 2007-01-30 |
| 1558441238 | Kenneth D Miller | Internal Medicine | 16 Old Brookside Road, Randolph, NJ 07869 | 2006-10-16 |
| 1720021488 | Duane G. Sossong | Internal Medicine | 121 Center Grove Rd Ste 17, Randolph, NJ 07869 | 2006-06-13 |
| 1720020225 | Dannette Arboleda-marin | Internal Medicine | 447 Route 10 E Ste 15, Randolph, NJ 07869-2132 | 2006-06-11 |
| 1659348142 | Kishwar Shareef | Internal Medicine | 447 Route 10 E, Suite 15, Randolph, NJ 07869-2132 | 2006-03-02 |
| 1386618148 | Dorina R Abdulah | Internal Medicine | 32 South Main St., Suite 200, Randolph, MA 02368 | 2006-02-16 |
| 1376158436 | Steven F Lewis | Internal Medicine | 1202 Sussex Tpke, Randolph, NJ 07869-2939 | 2020-09-14 |
| Find all providers in RANDOLPH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.