Active NPI
Carmen K Goojha, M.D.
- Family Medicine Physician
- Pawtucket, RI
National Provider Identifier
1891040945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LP02531
- Practice address
- 111 Brewster St
FCC Team C
Pawtucket, RI 02860-4474 - Phone
- (401) 729-2769
- Fax
- (401) 729-2772
- NPI assigned
- Jul 16, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LP02531 | RI | Primary |
Addresses
Primary practice location
111 Brewster St
FCC Team C
Pawtucket, RI 02860-4474
Mailing address
111 Brewster St
FCC Team C
Pawtucket, RI 02860-4474
Phone (401) 729-2769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LP02531 | Other | RI | RHODE ISLAND LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140714001414 | RI | Order and Referring Only - Family Practice | 2567687239 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342396800000",
"number": "1891040945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 BREWSTER ST",
"address_2": "FCC TEAM C",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604474",
"telephone_number": "401-729-2769",
"fax_number": "401-729-2772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 BREWSTER ST",
"address_2": "FCC TEAM C",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604474",
"telephone_number": "401-729-2769",
"fax_number": "401-729-2772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOJHA",
"first_name": "CARMEN",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-16",
"last_updated": "2012-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "RI",
"license": "LP02531",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RHODE ISLAND LICENSE",
"identifier": "LP02531",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.