Thomas Carl Golubski, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

010135170A Issued in IN

Practice address

90 W 86TH Ave
Merrillville, IN 46410-7086

Phone

(219) 791-1555

Fax

(219) 791-1560

NPI assigned

Jun 30, 2005

Last updated

Dec 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• St Mary Medical Center Inc

  • Rehabilitation Hospital Unit
  • Hobart, IN
  • NPI 1184726390

  Corporate Director

  CMS ownership
• St Mary Medical Center Inc

  dba Home Health of St Mary Medical Center

  • Home Health Agency
  • Hobart, IN
  • NPI 1528160736

  Corporate Director

  CMS ownership
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745

  Corporate Director

  CMS ownership
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175

  Corporate Director

  CMS ownership

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.

• Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1124069182
  Medicare reassignment
• Fort Wayne Vascular Care LLC

  dba Nephrology Associates of Northern Indiana PC

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
  • NPI 1225684368

  Nephrology

  NPD
• Nani Lab LLC

  • Clinical Medical Laboratory
  • Oak Brook, IL
  • NPI 1811472186
  NPD (past)
• Nani-Ihp LLC

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1417376385
  NPD (past)
• Willow Springs Surgery Center, LLC

  dba NANI Vascular at Addison

  • Ambulatory Surgical Clinic/Center
  • Addison, IL
  • NPI 1467429233
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1639176118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W 86TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107086",
            "telephone_number": "219-791-1555",
            "fax_number": "219-791-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUBSKI",
        "first_name": "THOMAS",
        "middle_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036069902",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "010135170A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082060",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000095602",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100360520B",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gogo Trans Inc.
• Golden Years Care LLC
• Nazar Golewale, MD
• Gabrielle Imani Golston
• Martrell Javon Golston, PHARMD
• Brenda Gomez, BA
• Ivana Mari Gomez, BA
• Jacob Gomez
• Ayoola K Gomih, M.D.
• Katrina Gonzales

• Nephrology Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Nephrology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.