Individual provider Active NPI

Naba Goswami, MD

  • Internal Medicine Physician
  • St Clairsville, OH
National Provider Identifier
1053471672
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35069006 Issued in OH
Practice address
109 Plaza Dr
St Clairsville, OH 43950
Phone
(740) 695-2609
Fax
(740) 695-2877
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35069006 OH
Internal Medicine Physician 207R00000X 35069006 OH Primary

Addresses

Primary practice location

109 Plaza Dr
St Clairsville, OH 43950

Mailing address

PO Box 6230
Wheeling, WV 26003-0722
Phone (740) 695-2609

Other identifiers 2

IdentifierTypeStateIssuer
0948149MedicaidOH
110141077OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080923000019 OH Practitioner - Internal Medicine 5395812093 Practice locations: Martins Ferry, OH; Saint Clairsville, OH; St Clairsville, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Mario C Mejia PC Internal Medicine Past Accepting new patients
Cleveland Prime Care Belmont LLC Internal Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1053471672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6230",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030722",
            "telephone_number": "740-695-2609",
            "fax_number": "740-695-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PLAZA DR",
            "city": "ST CLAIRSVILLE",
            "state": "OH",
            "postal_code": "43950",
            "telephone_number": "740-695-2609",
            "fax_number": "740-695-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSWAMI",
        "first_name": "NABA",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35069006",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35069006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0948149",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110141077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clairsville, OH

Sources for this page

Verify at the official NPI Registry.