Individual provider Active NPI

Dennis Golis, RPAC

  • Surgical Physician Assistant
  • New Hartford, NY
National Provider Identifier
1114909892
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
011999 Issued in NY
Practice address
1729 Burrstone Rd
New Hartford, NY 13413
Phone
(315) 798-1617
Fax
(315) 624-1926
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 011999 NY Primary

Addresses

Primary practice location

1729 Burrstone Rd
New Hartford, NY 13413

Mailing address

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (318) 798-1702

Other identifiers 1

IdentifierTypeStateIssuer
03974729MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071113000532 NY Practitioner - Physician Assistant 8921059205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesee Orthopedics and Hand Surgery Associates PCGroup PAC ID 0941343768, 13 clinicians

Practice addresses (Care Compare)

415 E 37TH St
Apt 21a
New York, NY 10016-3243
Phone (313) 525-1310

4401 Middle Settlement Rd
Suite 102
New Hartford, NY 13413-5332
Phone (315) 735-4496

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
79.61
Promoting interoperability
94
Improvement activities
40
Cost
91.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011999NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedicsny, LLP Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dennisg@gohs.medentdirect.com

Organizations & group practices 3

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 1

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1114909892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "318-798-1702",
            "fax_number": "315-798-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "13413",
            "telephone_number": "315-798-1617",
            "fax_number": "315-624-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLIS",
        "first_name": "DENNIS",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03974729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.