Goshen Medical Practice,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01054743A Issued in IN

Legal business name

GOSHEN MEDICAL PRACTICE,LLC

Practice address

2240 Karisa Dr
Suite1
Goshen, IN 46526-6943

Phone

(574) 534-6757

Fax

(574) 537-0357

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dicky G Bhagat, M.D.NPI 1518960525

Title

Sole Properitor of LLC

Phone

(574) 534-6757

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HCDAAA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dicky Girish Bhagat, M.D

  • Internal Medicine Physician
  • Goshen, IN
  • NPI 1518960525
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1861582694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 KARISA DR",
            "address_2": "SUITE1",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266943",
            "telephone_number": "574-534-6757",
            "fax_number": "574-537-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 KARISA DR",
            "address_2": "SUITE1",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266943",
            "telephone_number": "574-534-6757",
            "fax_number": "574-537-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL PRACTICE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "BHAGAT",
        "authorized_official_first_name": "DICKY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE PROPERITOR OF LLC",
        "authorized_official_telephone_number": "574-534-6757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01054743A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goshen Hospital Association Inc
• Goshen Hospital Association Inc
• Goshen Hospital Association Inc
• Goshen Hospital Association, Inc
• Goshen Hospital Association, Inc.
• Goshen Orthopedic Associates, LLC
• Goshen Orthopedic Associates, LLC
• Goshen Surgical Associates, Inc.
• Jessica Gotwals
• Jonathan C Graber, NP

• Internal Medicine Physician in Goshen, IN
• Providers in Goshen, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.