MICHAEL GOTTLIEB (NPI# 1861713034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861713034 |
| Entity Type | Individual |
| Full Name | MICHAEL GOTTLIEB |
| Credential | M.D. |
| Practice Address |
1 Randall Sq Ste 205 Providence RI 02904-2709 |
| Practice Telephone | 4013316980 |
| Practice Fax Number | 4013318110 |
| Mailing Telephone | 4013316980 |
| Mailing Fax Number | 4013318110 |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2020-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | CDRH.0058420 | CO | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | MD14698 | RI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 360 Peak One Dr, Ste 260 Ob, Frisco, CO 80443 | 9706685771 | 9702622196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467867499 | Michael Gottlieb | Behavioral Analyst | 3724 1/2 Corinth Ave, Los Angeles, CA 90066-3440 | 2014-06-28 |
| 1215462205 | Michael S Gottlieb | Nurse Practitioner | 500 Peconic St, 92a, Ronkonkoma, NY 11779-7100 | 2017-04-27 |
| 1821355082 | Michael Gottlieb | Emergency Medicine | 1900 W Polk St, Dept of Emergency Medicine - 10th Floor, Chicago, IL 60612-3723 | 2012-04-12 |
| 1104940105 | Michael C Gottlieb | Psychologist | 12810 Hillcrest Rd, B224, Dallas, TX 75230-1525 | 2007-03-17 |
| 1851457683 | Michael N Gottlieb | Internal Medicine | Metrowest Medical Center, 67 Union Street, Natick, MA 01760 | 2006-12-28 |
| 1871506808 | Michael Stuart Gottlieb | Specialist | 5901 W Olympic Blvd, Suite 401, Los Angeles, CA 90036-4667 | 2006-08-14 |
| 1821066465 | Michael A Gottlieb | Otolaryngology | 5140 Liberty Ave Ste 102, Pittsburgh, PA 15224-2215 | 2006-03-09 |
| 1609858075 | Michael Milton Gottlieb | Surgery | 1320 El Capitan Dr, Suite 440, Danville, CA 94526-6258 | 2005-11-18 |
| Street Address |
1 RANDALL SQ STE 205 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02904-2709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629074752 | Magdalena G Krzystolik | Ophthalmology | 1 Randall Sq, Suite 203, Providence, RI 02904-2709 | 2005-06-23 |
| 1366051849 | Caroline S. Murray | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2020-07-30 |
| 1134744659 | Briana J. Bartone | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2020-06-10 |
| 1639717408 | Kaleena Crooks | Registered Nurse | 1 Randall Sq, Providence, RI 02904-2709 | 2019-12-12 |
| 1922657907 | Catherine Putko | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2019-09-11 |
| 1003383795 | Phina A Mayu | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2018-10-31 |
| 1982185526 | Takeysha A Duarte | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2018-08-22 |
| 1184104648 | Bridget M Andaloro | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2018-08-15 |
| 1649788258 | Caroline Miringu-ruitha | Nurse Practitioner | 1 Randall Sq, Providence, RI 02904-2709 | 2018-01-17 |
| 1083138572 | The Providence Community Health Centers, Inc | Clinic/Center | 1 Randall Sq, Providence, RI 02904-2709 | 2017-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235638354 | Rachel Blay | Obstetrics & Gynecology | 112 Langdon St, Providence, RI 02904-1111 | 2018-02-04 |
| 1831537208 | Courtney Noonan | Obstetrics & Gynecology | 695 Eddy St Ste 21, Providence, RI 02903-4938 | 2013-06-07 |
| 1801161484 | Smgri, PC | Obstetrics & Gynecology | 10 Weybosset St, Providence, RI 02903-2818 | 2012-03-15 |
| 1134415029 | Lindsey Beffa | Obstetrics & Gynecology | 101 Dudley St Fl 4, Providence, RI 02905-2401 | 2011-06-20 |
| 1487846648 | Anh-tai Vinh Dang | Obstetrics & Gynecology | 18 Imperial Pl, Ste 2d, Providence, RI 02903-4641 | 2007-08-13 |
| 1639231673 | Cassandra Leigh Carberry | Obstetrics & Gynecology | 101 Plain St Ste 5, Providence, RI 02903-4829 | 2006-12-15 |
| 1316046063 | Michael Sisitsky | Obstetrics & Gynecology | 101 Dudley St., Women and Infants Hospital-division of Triage, Providence, RI 02905 | 2006-09-21 |
| 1326140120 | Ob-gyn Associates Inc | Obstetrics & Gynecology | 1 Randall Square, Ste 205, Providence, RI 02904 | 2006-09-02 |
| 1649290024 | Mary Catherine Derosa | Obstetrics & Gynecology | 148 West River Street, Suite 8, Providence, RI 02904-2609 | 2006-07-20 |
| 1750311528 | Sarah Fox | Obstetrics & Gynecology | 148 West River Street Suite 8, Providence, RI 02904-2615 | 2006-07-04 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02904 |
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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.