Individual provider Active NPI

Mayuri P. Gothe, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Denver, CO
National Provider Identifier
1699000844
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
DR.0070088 Issued in CO
Practice address
777 Bannock St # Mc3240
Denver, CO 80204-4597
Phone
(303) 436-6000
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X DR.0070088 CO Primary
Pediatrics Physician 208000000X 125052457 IL
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME115701 FL

Addresses

Primary practice location

777 Bannock St # Mc3240
Denver, CO 80204-4597

Mailing address

601 S Broadway # Mc3240
Denver, CO 80209-4081
Phone (303) 436-6000

Other practice location 1

5955 Ponce De Leon Blvd.
Coral Gables, FL 33146
Phone (512) 363-9126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 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
I20160901002439 FL Practitioner - Pediatric Medicine 2769778638 Reassigns benefits to 1 organization
I20230504001243 CO Practitioner - Pediatric Medicine 2769778638 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125052457ILMDPediatrics Physician
DR.0070088COMDPediatric Emergency Medicine (Pediatrics) Physician
ME115701FLMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince May 26, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince May 26, 2023 Accepting new patients
Emergency Pediatric Services, PA CurrentSince Jun 20, 2016 Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668

Interoperability endpoints

  • Direct secure messaging: mgothe279130@direct.dhha.org

Organizations & group practices 3

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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1699000844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S BROADWAY # MC3240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094081",
            "telephone_number": "303-436-6000",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC3240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Ponce De Leon Blvd.",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "33146",
            "country_code": "US",
            "telephone_number": "512-363-9126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTHE",
        "first_name": "MAYURI",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "DR.0070088",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125052457",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME115701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.