NPIMap

Individual provider Active NPI

Anirban Ghosh, MD

  • Internal Medicine Physician
  • Kearney, NE
National Provider Identifier
1790063014
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28022 Issued in NE
Practice address
816 22ND Ave
Suite 100
Kearney, NE 68845-2206
Phone
(308) 865-2263
Fax
(308) 865-2541
NPI assigned
Aug 3, 2011
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28022 NE Primary

Addresses

Primary practice location

816 22ND Ave
Suite 100
Kearney, NE 68845-2206

Mailing address

816 22ND Ave
Suite 100
Kearney, NE 68845-2206
Phone (308) 865-2263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20140806001342 NE Practitioner - Internal Medicine 9830316306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryan Hospital KearneyGroup PAC ID 5991195547, 116 clinicians

Practice addresses (Care Compare)

816 22ND Ave
Suite 100
Kearney, NE 68845-2226
Phone (308) 865-2263

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28022NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Hospital Kearney Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Bryan Hospital Kearney CurrentSince Jan 1, 2022 Accepting new patients
Platte Valley Medical Group, P.C. Internal Medicine Past Accepting new patients
VSL Kearney LLC Past Accepting new patients

Locations

804 22nd Ave
Kearney, NE 68845
Phone (308) 455-3600

816 22nd Ave
Ste 100
Kearney, NE 68845
Phone (308) 865-2263

Interoperability endpoints

  • Direct secure messaging: aghosh52671@hisp.bryanhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brookestone GardensKearney, NE, CCN 285305 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control		 Mar 18, 2022
Mar 18, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • VSL Kearney LLC

    dba Brookestone Gardens

    • Skilled Nursing Facility
    • Kearney, NE
    • NPI 1437618576

    Contracted Managing Employee, Operational/Managerial Control

    CMS ownership

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1790063014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 22ND AVE",
            "address_2": "SUITE 100",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452206",
            "telephone_number": "308-865-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 22ND AVE",
            "address_2": "SUITE 100",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452206",
            "telephone_number": "308-865-2263",
            "fax_number": "308-865-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOSH",
        "first_name": "ANIRBAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "28022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.