Atta Goudarzi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD204618 Issued in OR

Practice address

1750 Thompson Rd
Coos Bay, OR 97420-2195

Phone

(541) 269-0333

NPI assigned

Jun 6, 2018

Last updated

Oct 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, NY2 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

Specialty

Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apogee Medical Group, New York, PCGroup PAC ID 4587793294, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Erie County Medical Center Hospital, Buffalo, NY, CCN 330219

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/bea62b1d-5b0c-4c1a-bdbd-eaa129312421/

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.

• Apogee Medical Group, New York, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1841520236

  NY

  Medicare reassignment Care Compare group NPD
• Bay Clinic

  • Specialist
  • Coos Bay, OR
  • NPI 1538174958
  Medicare reassignment NPD
• Cogent Medical Care PC

  • Internal Medicine Physician
  • East Patchogue, NY
  • NPI 1912941238
  Medicare reassignment NPD
• Erie County Medical Center Corporation

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1437197985
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Erie County Medical Center Corporation

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1437197985
  Care Compare affiliation

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1790277549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202195",
            "telephone_number": "541-269-0333",
            "fax_number": "716-898-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202195",
            "telephone_number": "541-269-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDARZI",
        "first_name": "ATTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD204618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gold Path Therapy LLC
• Marshall Goldberg, D.D.S., M.S.D.
• Gayle D Goldblatt, LCSW
• Kylie Gomes
• Paul Gonzales, CRM
• Grace and Hope Counseling, LLC
• Ciera Lorraine Gray, FNP
• Greator Missouri Imaging Associates LLC (Inspire Radiology)
• Barbara Green
• Margaret Anne Greendale, RPH

• Internal Medicine Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.