Active NPI
Pratima Goyal, MD
- Family Medicine Physician
- Brentwood, NY
National Provider Identifier
1306930136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 198368
- Practice address
- 1869 Brentwood Rd
Brentwood, NY 11717-4625 - Phone
- (631) 853-3400
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 198368 | NY | Primary |
Addresses
Primary practice location
1869 Brentwood Rd
Brentwood, NY 11717-4625
Mailing address
45 Cabriolet LN
Melville, NY 11747-1921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01769951 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Family Medicine | Current | Accepting new patients |
Locations
1869 Brentwood Rd
Brentwood, NY 11717
Phone (631) 416-5480
369 E Main St
Ste 3
East Islip, NY 11730
Phone (631) 581-4500
300 Community Dr
Plandome, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Interoperability endpoints
- pratimagoyal@nslijmedgr.allscriptsdirect.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306930136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 CABRIOLET LN",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117471921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1869 BRENTWOOD RD",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117174625",
"telephone_number": "631-853-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOYAL",
"first_name": "PRATIMA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "198368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01769951",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.