Active NPI
Luz Danelly Gotham, CRNA
- Certified Registered Nurse Anesthetist
- Youngstown, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 80909
- Practice address
- 8401 Market St
Youngstown, OH 44512-6725 - Phone
- (330) 729-2929
- Fax
- (330) 729-1841
- NPI assigned
- Feb 13, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN291902 | OH | |
| Certified Registered Nurse Anesthetist | 367500000X | 80909 | OH | Primary |
Addresses
Primary practice location
8401 Market St
Youngstown, OH 44512-6725
Mailing address
4135 Boardman Canfield Rd Ste 101
Canfield, OH 44406-9803
Phone (330) 286-5330
Other practice location 1
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3658
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2948654 | Medicaid | OH | |
| 000000602907 | Other | OH | ANTHEM |
| 11958330 | Other | CAQH | |
| 8244021 | Other | OH | MEDICARE PTAN |
| P00723133 | Other | OH | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, PA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1211 Wilmington Ave
New Castle, PA 16105-2516
1211 Wlmngtn Ave GRND FLR
Div of Pulm Allergy and Crit Care Med
New Castle, PA 16105-2516
Phone (724) 656-4660
2 Hot Meal St
Pittsburgh, PA 15203-2348
2200 Memorial Dr
Farrell, PA 16121-1357
Phone (412) 648-1983
815 Freeport Rd
Pittsburgh, PA 15215-3399
Phone (412) 784-4396
Hospital & facility affiliations
- Upmc Jameson
- Upmc Horizon
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.94 of 100
- Quality
- 61.89
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.58
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80909 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bel-Park Anesthesia Associates, Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| University of Pittsburgh Physicians | Current | Accepting new patients | |
| University of Pittsburgh Physicians | Current | Accepting new patients | |
| University of Pittsburgh Physicians | Current | Accepting new patients |
Locations
4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215
1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182
8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929
2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864
815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Gastroenterology Physician
- Pittsburgh, PA
- NPI 1619935004
-
- Anesthesiology Physician
- Youngstown, OH
- NPI 1508813528
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Pittsburgh, PA
- NPI 1033125455
-
- Diagnostic Radiology Physician
- Pittsburgh, PA
- NPI 1285692699
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Greenville, PA
- NPI 1225048838
-
- General Acute Care Hospital
- New Castle, PA
- NPI 1477538312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559779200000",
"number": "1922247998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 BOARDMAN CANFIELD RD STE 101",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444069803",
"telephone_number": "330-286-5330",
"fax_number": "330-286-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 MARKET ST",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445126725",
"telephone_number": "330-729-2929",
"fax_number": "330-729-1841"
}
],
"practiceLocations": [
{
"address_1": "1044 Belmont Ave",
"address_purpose": "LOCATION",
"city": "Youngstown",
"state": "OH",
"postal_code": "445041006",
"country_code": "US",
"telephone_number": "330-480-3658",
"fax_number": "330-480-3439",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOTHAM",
"first_name": "LUZ",
"middle_name": "DANELLY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-13",
"last_updated": "2019-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN291902",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "80909",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2948654",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000602907",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11958330",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "8244021",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00723133",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.