Ajanta Goswami, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

01050577 Issued in IN

Practice address

3620 W White River Blvd
Muncie, IN 47304-4286

Phone

(765) 288-1928

Fax

(765) 288-2032

NPI assigned

Feb 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Grant-Blackford Mental Health, Inc.

  • Community/Behavioral Health Agency
  • Marion, IN
  • NPI 1407848500
  Medicare reassignment NPD
• Meridian Health Services Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muncie, IN
  • NPI 1992755490
  Medicare reassignment NPD
• Grant-Blackford Mental Health, Inc.

  • Community/Behavioral Health Agency
  • Marion, IN
  • NPI 1437983103
  NPD
• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Montpelier, IN
  • NPI 1417838574
  NPD
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1376349316
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1407820392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044286",
            "telephone_number": "765-288-1928",
            "fax_number": "765-288-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSWAMI",
        "first_name": "AJANTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01050577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200237850",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina N Goodman, FNP-C
• Lacy Goodnight, RBT
• Deanna C Gorrell, NP
• Derek M Gosman, M.A.
• Jennifer Goss, R.N.
• Jordan Gosztola
• John Gothard
• Bernice R Graham, RN
• Bruce M Graham, MD
• Melissa Amber Graham, MA, BCBA

• Child & Adolescent Psychiatry Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Child & Adolescent Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.

Verify at the official NPI Registry.