Individual provider Active NPI

Ajay Gohil, MD

  • Pediatric Gastroenterology Physician
  • Albuquerque, NM
National Provider Identifier
1780757906
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD2022-0043 Issued in NM
Practice address
201 Cedar St SE Ste 4660
Albuquerque, NM 87106-4924
Phone
(505) 563-6530
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME 101913 FL
Pediatric Gastroenterology Physician 2080P0206X 01036719A IN
Pediatric Gastroenterology Physician 2080P0206X MD2022-0043 NM Primary

Addresses

Primary practice location

201 Cedar St SE Ste 4660
Albuquerque, NM 87106-4924

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 2

IdentifierTypeStateIssuer
015979100MedicaidFL
100110370AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20220205000129 NM Practitioner - Pediatric Medicine 4082674239 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 101913FLMDPediatric Gastroenterology Physician
01036719AINMDPediatric Gastroenterology Physician
MD2022-0043NMMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2022 Accepting new patients
Pediatric Gastroenterology Inc Pediatric Gastroenterology CurrentSince Jan 31, 2021 Accepting new patients
Presbyterian Healthcare Services Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4500 Business Park Blvd
Ste C10
Anchorage, AK 99503
Phone (907) 770-2880

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

201 Cedar St SE
Ste 4660
Albuquerque, NM 87106
Phone (505) 563-6530

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1780757906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 4660",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064924",
            "telephone_number": "505-563-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHIL",
        "first_name": "AJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME 101913",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IN",
            "license": "01036719A",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NM",
            "license": "MD2022-0043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015979100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100110370A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.