Active NPI
Arun Gosain, MD
- Plastic and Reconstructive Surgery Physician
- Chicago, IL
National Provider Identifier
1629029426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 036130553
- Practice address
- 225 E Chicago Ave # 63
Chicago, IL 60611-2991 - Phone
- (800) 543-7362
- NPI assigned
- May 15, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 036130553 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave # 63
Chicago, IL 60611-2991
Mailing address
225 E Chicago Ave # 63
Chicago, IL 60611-2991
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000503658 | Other | OH | ANTHEM |
| 002000117U | Other | HUMANA | |
| 2687025 | Other | OH | BCMH |
| 2687025 | Medicaid | OH | |
| 31604200 | Medicaid | WI | |
| 1022537400001 | Medicaid | PA | |
| 363574 | Other | OH | WELLCARE MEDICAID |
| 4610200 | Other | OH | AETNA |
| 000000216484 | Other | OH | UNISON |
| 1629029426 | Other | MI | MICHIGAN MEDICAID |
| 750613 | Other | OH | BUCKEYE MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036130553 | IL | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children'S Medical Group, LLC | Past | Accepting new patients | |
| Lurie Childrens Surgical Foundation Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Chicago, IL
- NPI 1992758544
-
- Pediatric Surgery Physician
- Chicago, IL
- NPI 1356822050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1629029426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE # 63",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE # 63",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "800-543-7362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSAIN",
"first_name": "ARUN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "IL",
"license": "036130553",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000503658",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "002000117U",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCMH",
"identifier": "2687025",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2687025",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31604200",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1022537400001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE MEDICAID",
"identifier": "363574",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4610200",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "000000216484",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN MEDICAID",
"identifier": "1629029426",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE MEDICAID",
"identifier": "750613",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.