Individual provider Active NPI

Wonedwossen Goshu, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1336241165
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
659056 Issued in TX
Practice address
6720 Bertner Ave Ste 200
Houston, TX 77030-2604
Phone
(323) 552-6668
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 659056 TX Primary

Addresses

Primary practice location

6720 Bertner Ave Ste 200
Houston, TX 77030-2604

Mailing address

6720 Bertner Ave Ste 200
Houston, TX 77030-2604
Phone (323) 552-6668

Other practice location 1

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone (713) 620-4000

Other identifiers 5

IdentifierTypeStateIssuer
171528607MedicaidTX
171528609MedicaidTX
P00905299OtherTXRAILROAD MEDICARE
171528608OtherTXCSHCN
87971UOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050127000417 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719937705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1919 Old Spanish TRL
Houston, TX 77054-2003

6720 Bertner Ave
Houston, TX 77030-2604

6770 Bertner Ave
Suite C 350
Houston, TX 77030-2604
Phone (713) 798-1000

7200 Cambridge St
Houston, TX 77030-4202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Apr 1, 2023 Accepting new patients
Health Guard Anesthesia Services (Hgas) Nurse Anesthetist, Certified Registered Current Accepting new patients
Baylor College of Medicine CurrentSince Apr 1, 2023 Accepting new patients
Texans Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2023 Accepting new patients

Locations

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

1631 North Loop W
Ste 300
Houston, TX 77008
Phone (713) 343-1080

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 4

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1336241165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "323-552-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "323-552-6668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2411 Fountain View Dr",
            "address_2": "Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770574817",
            "country_code": "US",
            "telephone_number": "713-620-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSHU",
        "first_name": "WONEDWOSSEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "659056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171528607",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171528609",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00905299",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "171528608",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87971U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.