Individual provider Active NPI

Israel Gohoho, PA-C

  • Physician Assistant
  • Springfield, MA
National Provider Identifier
1114738408
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA101376 Issued in MA
Practice address
100 Wason Ave Ste 120
Springfield, MA 01107-1179
Phone
(413) 241-2100
Fax
(413) 735-1986
NPI assigned
Jan 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 PA101376 MA Primary

Addresses

Primary practice location

100 Wason Ave Ste 120
Springfield, MA 01107-1179

Mailing address

100 Wason Ave Ste 120
Springfield, MA 01107-1179
Phone (413) 241-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250304003848 MA Practitioner - Physician Assistant 4587185715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Valley Urology, PCGroup PAC ID 7214972207, 15 clinicians

Practice addresses (Care Compare)

100 Wason Ave
Suite 120
Springfield, MA 01107-1119
Phone (413) 241-2100

100 Wason Ave
Suite 120
Springfield, MA 01107-1179

Hospital & facility affiliations

  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015
  • Baystate Franklin Medical Center Hospital, Greenfield, MA, CCN 220016
  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA101376MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology & Imaging, Inc. PastSince Jan 1, 2025 Accepting new patients

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 6

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": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1114738408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WASON AVE STE 120",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071179",
            "telephone_number": "413-241-2100",
            "fax_number": "413-735-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASON AVE STE 120",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071179",
            "telephone_number": "413-241-2100",
            "fax_number": "413-735-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHOHO",
        "first_name": "ISRAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.