Individual provider Active NPI

Bharat Gautam

  • Endocrinology, Diabetes & Metabolism Physician
  • Chillicothe, OH
National Provider Identifier
1053871756
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35.149608 Issued in OH
Practice address
272 Hospital Rd Ste 150
Chillicothe, OH 45601-9031
Phone
(740) 779-8268
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 35.149608 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

272 Hospital Rd Ste 150
Chillicothe, OH 45601-9031

Mailing address

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone (732) 324-5080

Other practice location 1

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone (732) 324-5080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.main.endocrine.diabetes@adena.medicity.net

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
I20241009002579 OH Practitioner - Endocrinology 7618408071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

272 Hospital Rd
Suite 150
Chillicothe, OH 45601-9031
Phone (740) 779-8840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.149608OHMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

272 Hospital Rd
Ste 6
Chillicothe, OH 45601

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

272 Hospital Rd
Ste 150
Chillicothe, OH 45601
Phone (740) 779-7070

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: bgautam1219920@direct.osumc.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1053871756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613654",
            "telephone_number": "732-324-5080",
            "fax_number": "732-324-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD STE 150",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031",
            "telephone_number": "740-779-8268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 New Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088613654",
            "country_code": "US",
            "telephone_number": "732-324-5080",
            "fax_number": "732-324-4669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "BHARAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "35.149608",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.main.endocrine.diabetes@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd Ste 150",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.