Organization Active NPI

Goshen Pediatrics, PC

  • Pediatrics Physician
  • Goshen, NY
National Provider Identifier
1073997623
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
189547 Issued in NY
Legal business name
GOSHEN PEDIATRICS, PC
Practice address
2002 Route 17M
Suite 8
Goshen, NY 10924
Phone
(845) 291-7059
Fax
(845) 291-0905
NPI assigned
Jul 14, 2015
Organization subpart
Yes
Parent organization
GOSHEN PEDIATRICS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Dr. James N Wapshare, MDNPI 1467545376
Title
Owner
Phone
(845) 291-7059

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 189547 NY Primary

Addresses

Primary practice location

2002 Route 17M
Suite 8
Goshen, NY 10924

Mailing address

2002 Route 17M
Suite 8
Goshen, NY 10924
Phone (845) 291-7059

Other identifiers 2

IdentifierTypeStateIssuer
01364167MedicaidNY
01L261OtherNYBC

Other names 1

  • Chester Pediatrics Former legal business name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0949500Goshen Pediatrics PC2002 Route 17 M-Suite 8, Goshen, NY 10924Certificate of waiverAug 3, 2026

National Provider Directory

National Provider Directory
Part of
Goshen Pediatrics PC

Locations

2002 Route 17M
Ste 8
Goshen, NY 10924
Phone (845) 291-7059

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHGIBD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1073997623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 ROUTE 17M",
            "address_2": "SUITE 8",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-7059",
            "fax_number": "845-291-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 ROUTE 17M",
            "address_2": "SUITE 8",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-7059",
            "fax_number": "845-291-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN PEDIATRICS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOSHEN PEDIATRICS, PC",
        "enumeration_date": "2015-07-14",
        "last_updated": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "WAPSHARE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-291-7059",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "189547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01364167",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "01L261",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chester Pediatrics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.