Individual provider Active NPI

Gopal Katkoria, M.D.

  • Internal Medicine Physician
  • Milford, CT
National Provider Identifier
1760836407
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
79413 Issued in CT
Practice address
300 Seaside Ave
Milford, CT 06460-4603
Phone
(203) 688-1734
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T5938 TX
Internal Medicine Physician 207R00000X 299507 NY
Internal Medicine Physician 207R00000X 79413 CT Primary

Addresses

Primary practice location

300 Seaside Ave
Milford, CT 06460-4603

Mailing address

PO Box 7
Buffalo, NY 14213-0007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CT2 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
I20220502000554 TX Practitioner - Internal Medicine 2062709348 Reassigns benefits to 2 organizations
I20241212001649 CT Practitioner - Internal MedicinePractitioner - Hospitalist 2062709348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

300 Seaside Ave
Milford, CT 06460-4603
Phone (203) 301-6261

Hospital & facility affiliations

  • Constellation Home Care Hospice, Norwalk, CT, CCN 071542
  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299507NYMDLicensed Practical Nurse
79413CTMDInternal Medicine Physician
T5938TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Mar 18, 2022 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Mar 18, 2022 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Dec 15, 2024 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Dec 15, 2024 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

201 Seton Pkwy
Round Rock, TX 78665
Phone (512) 324-1010

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: gkatkoria701086@direct.ynhh.org

Organizations & group practices 4

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 5

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1760836407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142130007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SEASIDE AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604603",
            "telephone_number": "203-688-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATKORIA",
        "first_name": "GOPAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T5938",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "299507",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "79413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.