Individual provider Active NPI

Somaria Gobadan, REGISTERED NURSE

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1801161278
Registry record updated Mar 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
468687-1 Issued in NY
Practice address
700 Baychester Ave
Bronx, NY 10475-1756
Phone
(718) 904-5650
Fax
(718) 904-5655
NPI assigned
Mar 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 468687-1 NY Primary
Ambulatory Care Registered Nurse 163WP2201X 468687-1 NY

Addresses

Primary practice location

700 Baychester Ave
Bronx, NY 10475-1756

Mailing address

700 Baychester Ave
Bronx, NY 10475-1756
Phone (718) 904-5650

Other identifiers 3

IdentifierTypeStateIssuer
468687-1OtherNYREGISTERED NURSE
0420022OtherNYREGISTERED NURSE
0420022OtherNYNURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
468687-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1332028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332028800000",
    "number": "1801161278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BAYCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104751756",
            "telephone_number": "718-904-5650",
            "fax_number": "718-904-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BAYCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104751756",
            "telephone_number": "718-904-5650",
            "fax_number": "718-904-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBADAN",
        "first_name": "SOMARIA",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-18",
        "last_updated": "2012-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "468687-1",
            "primary": true
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "468687-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "468687-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "0420022",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE",
            "identifier": "0420022",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.