Individual provider Active NPI

Nikita Goswami

  • Pediatric Rheumatology Physician
  • Phoenix, AZ
National Provider Identifier
1447677307
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
60916 Issued in AZ
Practice address
1919 E Thomas Rd Ste 200
Phoenix, AZ 85016-7710
Phone
(602) 933-0909
NPI assigned
Mar 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Rheumatology Physician 2080P0216X 60916 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd Ste 200
Phoenix, AZ 85016-7710

Mailing address

4444 N 25TH St Unit 40
Phoenix, AZ 85016-5645
Phone (330) 329-2580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200528002750 AZ Practitioner - Pediatric Medicine 0446470009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60916AZMDPediatric Rheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jun 1, 2020 Accepting new patients
Phoenix Children'S Hospital Current Accepting new patients
Phoenix Children'S Hospital, Inc. Past Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

6321 S Ellsworth Rd
Ste 114
Mesa, AZ 85212

9319 E Cadence Pkwy
Mesa, AZ 85212
Phone (602) 933-3400

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Ste 200
Phoenix, AZ 85016
Phone (602) 933-0909

1920 E Cambridge Ave
Ste 200
Phoenix, AZ 85006
Phone (602) 933-0965

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

6990 E Shea Blvd
Ste 104
Scottsdale, AZ 85254

Organizations & group practices 3

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1447677307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 N 25TH ST UNIT 40",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165645",
            "telephone_number": "330-329-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSWAMI",
        "first_name": "NIKITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2022-07-14",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "AZ",
            "license": "60916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.