Sandeep D Goswami, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN255889 Issued in GA

Practice address

1183 S Hairston Rd
Stone Mountain, GA 30088-2796

Phone

(404) 296-8858

NPI assigned

Jan 11, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Elina Healthcare IncGroup PAC ID 1153737408, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Elina Healthcare Inc

  • Family Medicine Physician
  • Norcross, GA
  • NPI 1467058743

  GA, Single Specialty

  Medicare reassignment Care Compare group NPD
• Tripleheart Wound Care

  • Clinic/Center
  • Centerville, GA
  • NPI 1558232942

  GA, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1750152518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 S HAIRSTON RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882796",
            "telephone_number": "404-296-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 S HAIRSTON RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882796",
            "telephone_number": "404-296-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSWAMI",
        "first_name": "SANDEEP",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN255889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichelle Gooden
• Cierra Goodwin
• Rondine O Gordon, RN
• Mulembet Gorfu, RN
• Fred Dexter Gose, MD
• Edward Marvin Gotlieb, MD
• Jaquelin Smith Gotlieb, MD
• Grace Medical Institute
• Jarred Augustus Graham, DDS
• Grant Services for the Disabled , Inc.

• All providers in Stone Mountain, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.