Individual provider Active NPI

Robert J Golder, CRNA

  • Certified Registered Nurse Anesthetist
  • Ridley Park, PA
National Provider Identifier
1124013461
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN505068L Issued in PA
Practice address
175 E Chester Pike
Ridley Park, PA 19078-2284
Phone
(215) 442-5085
Fax
(877) 329-2370
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN505068L PA Primary

Addresses

Primary practice location

175 E Chester Pike
Ridley Park, PA 19078-2284

Mailing address

PO Box 650782
Dallas, TX 75265-0782
Phone (302) 733-0806

Other identifiers 3

IdentifierTypeStateIssuer
P00835760OtherPARAILROAD MEDICARE PTAN
053606OtherPAAANA NUMBER
001910860MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000656 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072671940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Anesthesia Services PCGroup PAC ID 3173437613, 437 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (610) 645-2000

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (610) 526-3000

744 W Lancaster Ave
Wayne, PA 19082-2523
Phone (610) 645-2000

Hospital & facility affiliations

  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Pennsylvania, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2017 Accepting new patients
Pinnacle Mid-Atlantic Pain Medicine, PC Past Accepting new patients

Locations

1000 Dutch Ridge Rd
Beaver, PA 15009
Phone (724) 728-7000

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 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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1124013461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650782",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650782",
            "telephone_number": "302-733-0806",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782284",
            "telephone_number": "215-442-5085",
            "fax_number": "877-329-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN505068L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00835760",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA NUMBER",
            "identifier": "053606",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001910860",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridley Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.