Individual provider Active NPI

Deborah Troth Gobetz, MD

  • Emergency Medicine Physician
  • Concord, MA
National Provider Identifier
1619077971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
75079 Issued in MA
Practice address
133 Old Road to Nine Acre Corner
Emerson Hospital
Concord, MA 01742
Phone
(978) 287-3690
NPI assigned
Sep 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 75079 MA Primary

Addresses

Primary practice location

133 Old Road to Nine Acre Corner
Emerson Hospital
Concord, MA 01742

Mailing address

133 Old Road to Nine Acre Corner
Emerson Hospital
Concord, MA 01742
Phone (978) 287-3690

Other identifiers 1

IdentifierTypeStateIssuer
3091911MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050427001418 MA Practitioner - Emergency Medicine 9638118706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75079MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2009 Accepting new patients
Emerson Hospital Emergency Phy PC Emergency Medicine Past Accepting new patients

Locations

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619077971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO NINE ACRE CORNER",
            "address_2": "EMERSON HOSPITAL",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-287-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO NINE ACRE CORNER",
            "address_2": "EMERSON HOSPITAL",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-287-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBETZ",
        "first_name": "DEBORAH",
        "middle_name": "TROTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "75079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3091911",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.