Individual provider Active NPI

Soma Ghosh, MD

  • Pediatrics Physician
  • Richland, WA
National Provider Identifier
1629336169
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60591410 Issued in WA
Practice address
888 Swift Blvd
Richland, WA 99352-3514
Phone
(509) 946-4611
Fax
(509) 942-3128
NPI assigned
May 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60591410 WA Primary

Addresses

Primary practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

560 Gage Blvd
Suite 203
Richland, WA 99352-8650
Phone (509) 942-3627

Other identifiers 2

IdentifierTypeStateIssuer
2048243MedicaidWA
500692779OtherWADMAP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20151105001953 WA Practitioner - Pediatric Medicine 7113176470 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Nov 20, 2019 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Nov 20, 2019 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 2, 2016 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 2, 2016 Accepting new patients
Yakima Valley Memorial Hospital Association Past Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

560 Gage Blvd
Ste 203
Richland, WA 99352
Phone (509) 942-3135

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Interoperability endpoints

  • Direct secure messaging: sghosh1108769@wm.providencedirect.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ef853cc1-94e4-4ed7-883a-9be7485e458e/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1629336169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528650",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-946-4611",
            "fax_number": "509-942-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOSH",
        "first_name": "SOMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60591410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048243",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMAP",
            "identifier": "500692779",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.