Individual provider Active NPI

Varun Goswami, MD

  • Physical Medicine & Rehabilitation Physician
  • Smithfield, NC
National Provider Identifier
1730616707
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2021-01410 Issued in NC
Practice address
100 Kellie Dr
Smithfield, NC 27577-9444
Phone
(919) 220-5255
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2021-01410 NC Primary

Addresses

Primary practice location

100 Kellie Dr
Smithfield, NC 27577-9444

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Other practice location 1

2196 Hwy 42 West
Clyaton, NC 27520-8343
Phone (919) 220-5255

Other identifiers 1

IdentifierTypeStateIssuer
2021-01410OtherNCSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210830000070 NC Practitioner - Physical Medicine and Rehabilitation 4486923414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

100 Kellie Dr
Smithfield, NC 27577-9444
Phone (919) 934-1094

Hospital & facility affiliations

  • Johnston Health Hospital, Smithfield, NC, CCN 340090

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-01410NCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physical Medicine & Rehabilitation CurrentSince Nov 15, 2022 Accepting new patients
Emergeortho PA CurrentSince Nov 15, 2022 Accepting new patients

Locations

2196 Veterans Pkwy
Clayton, NC 27520
Phone (919) 763-1050

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

100 Kellie Dr
Smithfield, NC 27577
Phone (919) 934-1094

Interoperability endpoints

  • Direct secure messaging: varun.goswami.1@847.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1730616707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KELLIE DR",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275779444",
            "telephone_number": "919-220-5255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2196 Hwy 42 West",
            "address_purpose": "LOCATION",
            "city": "Clyaton",
            "state": "NC",
            "postal_code": "275208343",
            "country_code": "US",
            "telephone_number": "919-220-5255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSWAMI",
        "first_name": "VARUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2021-01410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2021-01410",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

Verify at the official NPI Registry.