NPIMap

Individual provider Active NPI

Radharamanamurthy Gokula, M.D.

  • Family Medicine Physician
  • Perrysburg, OH
National Provider Identifier
1720089139
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35089833 Issued in OH
Practice address
11201 Sandusky St Ste 101
Perrysburg, OH 43551-3130
Phone
(419) 214-1213
Fax
(419) 214-0783
NPI assigned
Aug 9, 2005
Last updated
Jan 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35089833 OH Primary

Addresses

Primary practice location

11201 Sandusky St Ste 101
Perrysburg, OH 43551-3130

Mailing address

11201 Sandusky St Ste 101
Perrysburg, OH 43551-3130
Phone (419) 214-1213

Other identifiers 1

IdentifierTypeStateIssuer
4643573MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070712000833 OH Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 7315908258 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stay Home I Will, LLCGroup PAC ID 6305125667, 2 clinicians

Practice addresses (Care Compare)

2230 W Laskey Rd
Toledo, OH 43613-3543
Phone (419) 214-1213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35089833OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stay Home I Will, LLC Family Medicine CurrentSince Aug 4, 2016 Accepting new patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Family Medicine CurrentSince Jun 27, 2016 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Northwest Ohio Emergency Services, Inc. Past Accepting new patients
Noes/Paulding, LTD Past Accepting new patients
Headspace Counseling Services, LLC PastSince Feb 25, 2026 Accepting new patients
Astoria Place of Waterville LLC Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

11201 Sandusky St
Ste 101
Perrysburg, OH 43551
Phone (419) 874-2263

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2230 W Laskey Rd
Toledo, OH 43613
Phone (419) 214-1213

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1720089139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 SANDUSKY ST STE 101",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513130",
            "telephone_number": "419-214-1213",
            "fax_number": "419-214-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 SANDUSKY ST STE 101",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513130",
            "telephone_number": "419-214-1213",
            "fax_number": "419-214-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOKULA",
        "first_name": "RADHARAMANAMURTHY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35089833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4643573",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.