Individual provider Active NPI

Gopalkrisha M Trivedi, MD

  • Anatomic Pathology Physician
  • Lewistown, PA
National Provider Identifier
1124017645
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD 023488 E Issued in PA
Practice address
400 Highland Ave
Lewistown Hospital
Lewistown, PA 17044-1167
Phone
(717) 242-7208
Fax
(717) 242-7540
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X MD 023488 E PA Primary

Addresses

Primary practice location

400 Highland Ave
Lewistown Hospital
Lewistown, PA 17044-1167

Mailing address

PO Box 750
Scranton, PA 18501-0750
Phone (570) 346-7797

Other identifiers 1

IdentifierTypeStateIssuer
0009395050004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 023488 EPAMDAnatomic Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1124017645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 750",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185010750",
            "telephone_number": "570-346-7797",
            "fax_number": "570-342-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "address_2": "LEWISTOWN HOSPITAL",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441167",
            "telephone_number": "717-242-7208",
            "fax_number": "717-242-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "GOPALKRISHA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD 023488 E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009395050004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.