Individual provider Active NPI

Puja Sheth Gogawale, M.D.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1093151573
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036143697 Issued in IL
Practice address
1701 W Superior St FL 2
Chicago, IL 60622-5646
Phone
(312) 666-3494
NPI assigned
May 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036143697 IL Primary
Obstetrics & Gynecology Physician 207V00000X 125.063473 IL

Addresses

Primary practice location

1701 W Superior St FL 2
Chicago, IL 60622-5646

Mailing address

250 E Superior St
Chicago, IL 60611-2914
Phone (312) 926-2000

Other practice location 1

250 E Superior St
Chicago, IL 60611-2914
Phone (312) 926-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170927002069 IL Practitioner - Obstetrics/Gynecology 5092025072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians

Practice addresses (Care Compare)

1504 S Albany Ave
Chicago, IL 60623-2209
Phone (312) 666-3494

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.063473ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc CurrentSince Feb 25, 2021 Accepting new patients
Little Company of Mary Affiliated Services Inc Obstetrics & Gynecology CurrentSince Sep 18, 2017 Accepting new patients
Little Company of Mary Affiliated Services Inc Current Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Feb 25, 2021 Accepting new patients

Locations

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200

2850 W 95th St
Ste 203
Evergreen Pk, IL 60805
Phone (708) 422-1222

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207

Interoperability endpoints

  • Direct secure messaging: pgogawale368514@direct.ochin.org

Organizations & group practices 5

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": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1093151573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112914",
            "telephone_number": "312-926-2000",
            "fax_number": "312-472-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W SUPERIOR ST FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225646",
            "telephone_number": "312-666-3494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112914",
            "country_code": "US",
            "telephone_number": "312-926-2000",
            "fax_number": "312-472-0141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOGAWALE",
        "first_name": "PUJA",
        "middle_name": "SHETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036143697",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125.063473",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.