Individual provider Active NPI

Sarah Gould, PA

  • Physician Assistant
  • Beavercreek, OH
National Provider Identifier
1053921650
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2510 Commons Blvd Ste 210
Beavercreek, OH 45431-3821
Phone
(937) 429-0607
Fax
(937) 429-0608
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2510 Commons Blvd Ste 210
Beavercreek, OH 45431-3821

Mailing address

2510 Commons Blvd Ste 210
Beavercreek, OH 45431-3821
Phone (937) 558-3062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222002373 OH Practitioner - Physician Assistant 6002286622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

6001 E Broad St
Columbus, OH 43213-1502
Phone (614) 234-6000

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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 2

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1053921650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-558-3062",
            "fax_number": "937-558-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-429-0607",
            "fax_number": "937-429-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "SARAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.