Individual provider Active NPI

Ankush Gosain, MD

  • Pediatric Surgery Physician
  • Charlottesville, VA
National Provider Identifier
1104047083
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
0101282900 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-7106
Phone
(434) 924-3627
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 0069182 CO
Pediatric Surgery Physician 2086S0120X 43864 TN
Pediatric Surgery Physician 2086S0120X 54986-20 WI
Pediatric Surgery Physician 2086S0120X 0101282900 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-7106

Mailing address

PO Box 749112
Atlanta, GA 30374-9112
Phone (434) 295-1000

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Other practice location 2

51 N Dunlap St
Ste. 235
Memphis, TN 38105-4625
Phone (901) 287-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230109001191 CO Practitioner - General SurgeryPractitioner - Pediatric Medicine 7416136320 Reassigns benefits to 1 organization
I20241125001597 VA Practitioner - General SurgeryPractitioner - Pediatric Medicine 7416136320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Pediatric Medicine
Education
Eastern Virginia Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-2325
Phone (434) 924-8129

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0069182COMDPediatric Surgery Physician
0101282900VAMDPediatric Surgery Physician
54986-20WIMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Oct 8, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jan 1, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jan 1, 2023 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1212 McConville Rd
Lynchburg, VA 24502
Phone (434) 237-8886

Interoperability endpoints

  • Direct secure messaging: agosain652778@direct.healthsystem.virginia.edu

Organizations & group practices 3

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 1

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1104047083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229087106",
            "telephone_number": "434-924-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N Dunlap St",
            "address_2": "Ste. 235",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381054625",
            "country_code": "US",
            "telephone_number": "901-287-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSAIN",
        "first_name": "ANKUSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CO",
            "license": "0069182",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TN",
            "license": "43864",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "WI",
            "license": "54986-20",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "VA",
            "license": "0101282900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.