Kishan Ketan Ghodasara, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MT231734 Issued in PA

Practice address

420 S 5TH Ave
West Reading, PA 19611-2143

Phone

(484) 628-8000

NPI assigned

Jul 3, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1497591044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 REGENCY DR",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541618",
            "telephone_number": "215-237-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHODASARA",
        "first_name": "KISHAN",
        "middle_name": "KETAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT231734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Wayne Geyer, MD
• Katherine Ghattas, PHARMD
• Hrayr Ghazaryan, M.D.
• John Brennan Ghee
• Madison Gheer
• Johnatan Gideon, PHARMD
• John Gigioli, M.D.
• Diane Gilbert
• Amanda Gilgore, RN
• Sara Gillander, PA-C

• Emergency Medicine Physician in West Reading, PA
• Providers in West Reading, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.