Individual provider Active NPI

Radhika Ghosh, M.B.B.S

  • Pediatric Pulmonology Physician
  • Charleston, WV
National Provider Identifier
1689057101
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
31143 Issued in WV
Practice address
830 Pennsylvania Ave Ste 103
Charleston, WV 25302-3389
Phone
(304) 388-1552
Fax
(304) 388-1565
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 295705 NY
Pediatric Pulmonology Physician 2080P0214X 82944 GA
Student in an Organized Health Care Education/Training Program 390200000X NY
Pediatric Pulmonology Physician 2080P0214X 31143 WV Primary

Addresses

Primary practice location

830 Pennsylvania Ave Ste 103
Charleston, WV 25302-3389

Mailing address

830 Pennsylvania Ave Ste 103
Charleston, WV 25302-3389
Phone (304) 388-1552

Other practice location 1

1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone (404) 785-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, NY2 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
I20220916000541 WV Practitioner - Pediatric Medicine 7012392723 Reassigns benefits to 1 organization
I20260212000074 NY Practitioner - Pediatric Medicine 7012392723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295705NYMDPediatrics Physician
82944GAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 1, 2026 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 1, 2026 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 24, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 24, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

8622 Bay Pkwy
Ste 2D
Brooklyn, NY 11214
Phone (718) 372-8318

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

900 South Ave
Ste 103
Staten Island, NY 10314
Phone (718) 226-2950

830 Pennsylvania Ave
Ste 103
Charleston, WV 25302
Phone (304) 388-2525

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Interoperability endpoints

  • Direct secure messaging: rghosh384588@northwell.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1689057101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE STE 103",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023389",
            "telephone_number": "304-388-1552",
            "fax_number": "304-388-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE STE 103",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023389",
            "telephone_number": "304-388-1552",
            "fax_number": "304-388-1565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221060",
            "country_code": "US",
            "telephone_number": "404-785-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOSH",
        "first_name": "RADHIKA",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "295705",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "GA",
            "license": "82944",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "WV",
            "license": "31143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.