Individual provider Active NPI

Luz Danelly Gotham, CRNA

  • Certified Registered Nurse Anesthetist
  • Youngstown, OH
National Provider Identifier
1922247998
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
80909 Issued in OH
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

Updated by the provider on Jun 6, 2019

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 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

IdentifierTypeStateIssuer
2948654MedicaidOH
000000602907OtherOHANTHEM
11958330OtherCAQH
8244021OtherOHMEDICARE PTAN
P00723133OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090406000294 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648327890 Reassigns benefits to 1 organization
I20230912001519 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648327890 Reassigns benefits to 1 organization

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
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

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 Hospital, New Castle, PA, CCN 390016
  • Upmc Horizon Hospital, Greenville, PA, CCN 390178

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80909OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bel-Park Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 20, 2009 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 9, 2023 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 9, 2023 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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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.

Verify at the official NPI Registry.