Individual provider Active NPI

Golam Rosul Gazi, M.D.

  • Gastroenterology Physician
  • Wethersfield, CT
National Provider Identifier
1427076330
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
17479 Issued in CT
Practice address
350 Silas Deane Hwy
Wethersfield, CT 06109-1700
Phone
(860) 529-8670
Fax
(860) 529-8790
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 17479 CT Primary

Addresses

Primary practice location

350 Silas Deane Hwy
Wethersfield, CT 06109-1700

Mailing address

350 Silas Deane Hwy
Wethersfield, CT 06109-1700
Phone (860) 529-8670

Other identifiers 8

IdentifierTypeStateIssuer
OV7812OtherCTHEALTHNET
001174796OtherCTUNITED HEALTHCARE
054027OtherCTCONNECTICARE
010017479CT01OtherCTBLUE CROSS BLUE SHIELD
001174796MedicaidCT
4227408OtherCTAETNA
P1933998OtherCTOXFORD
2379856OtherCTAETNA US HEALTHCARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ggazi15727@direct.stfranciscare.org Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20081029000459 CT Practitioner - GastroenterologyPractitioner - Internal Medicine 1153489745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 3, 2020 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Nov 1, 2008 Accepting new patients
Prime Healthcare, PC Gastroenterology CurrentSince Nov 1, 2008 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 3, 2020 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

350 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 529-8670

350 Silas Deane Hwy
Ste 102
Wethersfield, CT 06109
Phone (860) 529-8670

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

Interoperability endpoints

  • Direct secure messaging: ggazi2390294@direct.trinity-health.org

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 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1427076330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091700",
            "telephone_number": "860-529-8670",
            "fax_number": "860-529-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091700",
            "telephone_number": "860-529-8670",
            "fax_number": "860-529-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZI",
        "first_name": "GOLAM",
        "middle_name": "ROSUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "17479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OV7812",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "001174796",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "054027",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010017479CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001174796",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4227408",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1933998",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "2379856",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggazi15727@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "350 Silas Deane Hwy",
            "city": "Wethersfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061091700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.