Individual provider Active NPI

Golbahar Houshmand, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1629357462
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.151440 Issued in IL
Practice address
676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone
(312) 695-0730
NPI assigned
Aug 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD457104 PA
Diagnostic Radiology Physician 2085R0202X 036.151440 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 800
Chicago, IL 60611-2978

Mailing address

200 Lothrop St Ste 3950
Pittsburgh, PA 15213-2536
Phone (412) 647-9729

Other practice location 1

200 Lothrop St Ste 3950
Pittsburgh, PA 15213-2536
Phone (412) 647-9729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IL2 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
I20160919001319 PA Practitioner - Diagnostic Radiology 6608163688 Reassigns benefits to 2 organizations
I20200401001961 IL Practitioner - Diagnostic Radiology 6608163688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

250 E Superior
2304 Nwmff Prent WMN Hosp
Chicago, IL 60611-2914
Phone (312) 472-3660

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.151440ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation Diagnostic Radiology CurrentSince May 20, 2020 Accepting new patients
University of Pittsburgh Physicians Diagnostic Radiology CurrentSince Jul 17, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 20, 2020 Accepting new patients
Regional Health Services Inc CurrentSince Apr 3, 2018 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

250 E Superior St
Fl 4
Chicago, IL 60611
Phone (312) 472-0436

250 E Superior St
#32304
Chicago, IL 60611
Phone (208) 703-2139

676 N Saint Clair St
Ste 800
Chicago, IL 60611
Phone (312) 695-5753

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

201 State St
Erie, PA 16550
Phone (814) 877-2137

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

2 Hot Metal St
Ste 1
Pittsburgh, PA 15203

200 Lothrop St
Ste 3950
Pittsburgh, PA 15213
Phone (412) 647-2273

Organizations & group practices 5

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 2

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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1629357462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST STE 3950",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536",
            "telephone_number": "412-647-9729",
            "fax_number": "412-802-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112978",
            "telephone_number": "312-695-0730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lothrop St Ste 3950",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132536",
            "country_code": "US",
            "telephone_number": "412-647-9729",
            "fax_number": "412-802-8221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUSHMAND",
        "first_name": "GOLBAHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD457104",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.151440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.