Active NPI
Deborah Troth Gobetz, MD
- Emergency Medicine Physician
- Concord, MA
National Provider Identifier
1619077971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 75079
- 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, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3091911 | Medicaid | MA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75079 | MA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emerson Emergency Physicians LLC | Emergency Medicine | Current | 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.
-
- Emergency Medicine Physician
- Concord, MA
- NPI 1972742542
-
- Emergency Medicine Physician
- Concord, MA
- NPI 1629039284
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.