Individual provider Active NPI

Jaime Goss, MPT, PT

  • Physical Therapist
  • Middletown, RI
National Provider Identifier
1164642187
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20842 Issued in MA
Practice address
73 Valley Rd
Middletown, RI 02842-5234
Phone
(401) 726-7100
Fax
(401) 433-0612
NPI assigned
May 1, 2007
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT02648 RI
Physical Therapist 225100000X 20842 MA Primary

Addresses

Primary practice location

73 Valley Rd
Middletown, RI 02842-5234

Mailing address

4 Richmond SQ Ste 200
Providence, RI 02906-5117
Phone (401) 726-7100

Other identifiers 3

IdentifierTypeStateIssuer
110121031AMedicaidMA
1801OtherAKLICENSE#
12109OtherNCLICENSE#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, RI, MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050418001085 CA Practitioner - Physical Therapist in Private Practice 4183662471 Reassigns benefits to 1 organization
I20160202000199 RI Practitioner - Physical Therapist in Private Practice 4183662471 Reassigns benefits to 2 organizations
I20170223002403 MA Practitioner - Physical Therapist in Private Practice 4183662471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy LLCGroup PAC ID 1951295187, 73 clinicians
Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians

Practice addresses (Care Compare)

180 County Rd
Suite 9C
Barrington, RI 02806-4544
Phone (401) 352-4444

73 Valley Rd
Middletown, RI 02842-5234
Phone (401) 289-2170

Merit-based Incentive Payment System (MIPS)

Final score
80.9 of 100Reported as group
Quality
79.21
Improvement activities
40
Cost
74.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20842MAMDDentist
PT02648RIMDPhysical Therapist
26029CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Oct 24, 2022 Accepting new patients
Bay State Physical Therapy PC Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Feb 12, 2020 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Oct 24, 2022 Accepting new patients
W. Seth Bolling, MD, Inc Past Accepting new patients
Physical Therapy Specialists Inc Physical Therapist PastSince Apr 15, 2000 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

1 Credit Union Way
Fl 3
Randolph, MA 02368
Phone 7819613370225

721 Reservoir Ave
Cranston, RI 02910
Phone (401) 946-4250

73 Valley Rd
Middletown, RI 02842
Phone (401) 289-2170

4 Richmond Sq
Ste 200
Providence, RI 02906

401 Elmgrove Ave
Providence, RI 02906
Phone (401) 421-4111

41 Sanderson Rd
Ste 101
Smithfield, RI 02917
Phone (401) 349-4540

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1164642187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-726-7100",
            "fax_number": "401-433-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425234",
            "telephone_number": "401-726-7100",
            "fax_number": "401-433-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSS",
        "first_name": "JAIME",
        "name_prefix": "Mrs.",
        "credential": "MPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02648",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110121031A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "1801",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "12109",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.