Individual provider Active NPI

Himan Goli, M.D

  • Internal Medicine Physician
  • Cheverly, MD
National Provider Identifier
1558679993
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD449018 Issued in PA
Practice address
3001 Hospital Drive
Cheverly, MD 20785
Phone
(301) 618-3774
NPI assigned
Sep 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD449018 PA Primary
Hospitalist Physician 208M00000X MD449018 PA

Addresses

Primary practice location

3001 Hospital Drive
Cheverly, MD 20785

Mailing address

3001 Hospital Dr
Cheverly, MD 20785-1189
Phone (301) 618-3774

Other identifiers 1

IdentifierTypeStateIssuer
558108700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200512001758 CA Practitioner - Internal Medicine 6901047570 Reassigns benefits to 1 organization
I20201119002377 TX Practitioner - Internal Medicine 6901047570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Pat Associates PA Internal Medicine CurrentSince Sep 29, 2020 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Apr 6, 2020 Accepting new patients
St Davids Healthcare Partnership LP LLP Past Accepting new patients

Locations

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

23900 Katy Fwy
Katy, TX 77494
Phone (281) 644-7000

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1558679993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DRIVE",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "20785",
            "telephone_number": "301-618-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLI",
        "first_name": "HIMAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-20",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD449018",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD449018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558108700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheverly, MD

Sources for this page

Verify at the official NPI Registry.