GOSHEN SURGICAL ASSOCIATES, INC. (NPI# 1093823908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093823908 |
| Entity Type | Organization |
| Organization Name | GOSHEN SURGICAL ASSOCIATES, INC. |
| Practice Address |
101 Marilyn Ave Suite 4 Goshen IN 46526-4800 |
| Practice Telephone | 5745332769 |
| Practice Fax Number | 5745346822 |
| Mailing Telephone | 5745332769 |
| Mailing Fax Number | 5745346822 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2011-01-24 |
| Authorized Official Name | JOHN W HARLEY (VICE PRESIDENT) |
| Authorized Official Telephone | 5745332769 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 50001564A | IN | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
50001564A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100384730 | 05 |
| Street Address |
101 MARILYN AVE SUITE 4 |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396727020 | Jon E Smucker | Surgery | 101 Marilyn Ave, Suite 4, Goshen, IN 46526-4800 | 2005-11-17 |
| 1649252388 | John W Harley | Surgery | 101 Marilyn Ave, Suite 4, Goshen, IN 46526-4800 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326385428 | Hossein L. Tehrani | Surgery | 49 East Hyerdale Drive, Goshen, CT 06756 | 2013-01-09 |
| 1326093972 | Hudson Valley Thoracic & Vascular Assoc. Pllc | Surgery | 70 Hatfield Ln, Suite 202, Goshen, NY 10924-6734 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801456603 | Wickel Vascular Surgery & Medicine PC | Surgery | 1919 State St Ste 444, New Albany, IN 47150-6809 | 2019-06-14 |
| 1154832178 | Allied Physicians of Michiana, LLC | Surgery | 611 E Douglas Rd Ste 308, Mishawaka, IN 46545-1465 | 2017-10-17 |
| 1194041764 | Andrew Alexander Gonzalez | Surgery | 1801 N Senate Blvd Ste 3500, Indianapolis, IN 46202-1184 | 2010-04-08 |
| 1649468364 | South Bend Vein Center for Excelllence, LLC | Surgery | 2025 Edison Rd, South Bend, IN 46637-5599 | 2007-10-09 |
| 1396938031 | Peripheral Vascular Care | Surgery | 640 S Walker St, Bloomington, IN 47403-2158 | 2007-08-27 |
| 1285841502 | Decatur Vein Clinic Hobart, PC | Surgery | 5043 E Lincoln Hwy, Merrillville, IN 46410-5912 | 2007-05-17 |
| 1093881385 | Decatur Vein Clinic, Michigan, PC | Surgery | 645 W Carmel Dr, Suite 101, Carmel, IN 46032-2605 | 2006-11-28 |
| 1962508853 | Indiana Phlebology PC | Surgery | 371 E 84th Dr Ste 371, Merrillville, IN 46410-6484 | 2006-09-16 |
| 1447361928 | The Heart and Vascular Clinic, P.C. | Surgery | 3251 Shawnee Drive South, Bedford, IN 47421 | 2006-08-31 |
| 1487761607 | Abdolaziz M Ardalan | Surgery | 9737 Decatur Dr, Indianapolis, IN 46256-9656 | 2006-08-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.