Active NPI
Samuel J Goss, DO
- Cardiovascular Disease Physician
- Tavares, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 0506997
- Practice address
- 1879 Nightingale Lane
Suite C1
Tavares, FL 32778 - Phone
- (352) 742-1171
- Fax
- (352) 742-7241
- NPI assigned
- Jul 5, 2006
- Last updated
- Apr 30, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 0506997 | FL | Primary |
Addresses
Primary practice location
1879 Nightingale Lane
Suite C1
Tavares, FL 32778
Mailing address
1879 Nightingale Lane
Suite C1
Tavares, FL 32778
Phone (352) 742-1171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 378286700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1879 Nightingale LN
Suite A1 and C1
Tavares, FL 32778-4363
Phone (352) 742-1171
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0506997 | FL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Healthcare Partners, Inc | Current | Accepting new patients |
Locations
705 Doctors Ct
Leesburg, FL 34748
Phone (352) 323-5700
1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000
60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000
1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333
1879 Nightingale Ln
Ste A1
Tavares, FL 32778
Phone (352) 401-1919
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- sgoss59132@adventhealth.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Daytona Beach, FL
- NPI 1780100529
-
- Cardiovascular Disease Physician
- Tavares, FL
- NPI 1679508063
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Orlando
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
dba AdventHealth Orlando Outreach Laboratory
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
dba AdventHealth Waterman
- General Acute Care Hospital
- Tavares, FL
- NPI 1821019571
-
dba AdventHealth Daytona Beach
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1063426823
-
dba AdventHealth Daytona Beach
- Clinical Medical Laboratory
- Daytona Beach, FL
- NPI 1104696178
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367280000000",
"number": "1063443653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1879 NIGHTINGALE LANE",
"address_2": "SUITE C1",
"city": "TAVARES",
"state": "FL",
"postal_code": "32778",
"telephone_number": "352-742-1171",
"fax_number": "352-742-7241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1879 NIGHTINGALE LANE",
"address_2": "SUITE C1",
"city": "TAVARES",
"state": "FL",
"postal_code": "32778",
"telephone_number": "352-742-1171",
"fax_number": "352-742-7241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSS",
"first_name": "SAMUEL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2013-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "0506997",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "378286700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tavares, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.
- 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.