NPIMap

Individual provider Active NPI

Keith Goshay

  • Addiction (Substance Use Disorder) Counselor
  • Beaumont, CA
National Provider Identifier
1245862952
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
AII054020418 Issued in CA
Practice address
953 Avenal Way
Beaumont, CA 92223-8559
Phone
(951) 505-3552
NPI assigned
Feb 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X AII054020418 CA Primary

Addresses

Primary practice location

953 Avenal Way
Beaumont, CA 92223-8559

Mailing address

953 Avenal Way
Beaumont, CA 92223-8559
Phone (951) 505-3552

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL //192.168.1.1
CONNECT URL Beaumont Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AII054020418CAMDAddiction (Substance Use Disorder) Counselor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1245862952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 AVENAL WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922238559",
            "telephone_number": "951-505-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 AVENAL WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922238559",
            "telephone_number": "951-505-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSHAY",
        "first_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "AII054020418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "//192.168.1.1",
            "affiliation": "N",
            "address_1": "953 Avenal Way",
            "city": "Beaumont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922238559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Beaumont",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "953 Avenal Way",
            "city": "Beaumont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922238559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.