Panna U Goswami, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036061013 Issued in IL

Practice address

1604 Visa Dr Ste 1
Normal, IL 61761-2195

Phone

(815) 846-4716

Fax

(309) 323-0442

NPI assigned

Sep 12, 2005

Last updated

Jun 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Neuro Monitoring Services LLC

  • Physical Medicine & Rehabilitation Physician
  • Sycamore, IL
  • NPI 1568534162
  NPD Authorized official
• Neuromonitoring Service LLC

  • Physical Medicine & Rehabilitation Physician
  • Normal, IL
  • NPI 1467583955
  Authorized official Same address or phone
• Umesh P. Goswami MD SC

  dba Progressive Physical Medicine

  • Physical Medicine & Rehabilitation Physician
  • Dekalb, IL
  • NPI 1124207311
  NPD (past) Authorized official
• Advanced Medical & Wellness of Spring Hill, S.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Carpentersville, IL
  • NPI 1366408387
  NPD (past)
• Umesh P. Goswami, MD SC

  • Primary Care Clinic/Center
  • Dekalb, IL
  • NPI 1033393889
  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1871587303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "815-762-2535",
            "fax_number": "815-758-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "815-846-4716",
            "fax_number": "309-323-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSWAMI",
        "first_name": "PANNA",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036061013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-061013",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Goetze, PT, DPT
• Rebecca L Golladay, OTR-L
• Miranda Leigh Gonzalez, APN, CNP
• Ajeet D Gordhan, M.D.
• Tammy Gordon, RN
• Grace Medical Transport LLC
• Jeffrey Graham, MA, LCPC
• Kathryn Grahs
• Molly Grant
• Lawrence Vincent Gratkins, MD

• Physical Medicine & Rehabilitation Physician in Normal, IL
• Providers in Normal, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.