Michael Joseph Gould
Individual provider Active NPI Family Medicine Physician · Fairmount City, PA
NPI 1205182136 · NPPES record last updated Apr 7, 2022
Key facts
- NPI
- 1205182136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- OT014570 (PA)
- Practice address
- 82 Town Run Rd
Fairmount City, PA 16224-1502 - Phone
- (814) 275-1600
- NPI assigned
- Jul 30, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 4
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- West Virginia School of Osteopathic Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Potomac Valley Hospital of W VA , Inc
Practice addresses (Care Compare)
100 Pin Oak LN
Keyser, WV 26726-5908
Phone (304) 597-3500
Hospital & facility affiliations
- Potomac Valley Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Potomac Valley Hospital of W VA , Inc |
Hospital | Corporate Director | Aug 10, 2021 |
| Riverside Clinic |
Rural health clinic | Corporate Director | Aug 10, 2021 |
| Fort Ashby Rural Health Clinic of Potomac Valley Hospital |
Rural health clinic | Corporate Director | Aug 10, 2021 |
| Mineral County Rural Health Clinic of Potomac Valley Hospital |
Rural health clinic | Corporate Director | Aug 10, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140617000211 | WV | Practitioner - General Practice | 1759505670 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT014570 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Potomac Valley Hospital of W VA , Inc | Current |
Accepting new patients | |
| Potomac Valley Hospital of W VA , Inc | Family Medicine | Current |
Accepting new patients |
| Potomac Valley Hospital of WV, Inc. | Current |
Accepting new patients | |
| Potomac Valley Hospital of W VA , Inc | Past |
Accepting new patients |
Locations
100 Pin Oak Ln
Ste 3
Keyser, WV 26726
Phone (304) 597-3790
100 Pin Oak Ln
Keyser, WV 26726
Phone (304) 597-3500
Interoperability endpoints
- mgald107337@direct.wvuhsdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OT014570 | PA | Yes |
Addresses
Primary practice location
82 Town Run Rd
Fairmount City, PA 16224-1502
Mailing address
310 Greencrest Dr
Shippenville, PA 16254-4208
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgald107337@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | mgald107337@direct.wvuhsdirect.com | Health Information Exchange (HIE) |
Other providers in Fairmount City, PA
- Brookville Hospital
- Butler Medical Providers
- Cailin Nicole Byerly
- Dubois Regional Medical Center
- Tammy Ganoe
- Georgi Anne Grafton
- Health Services of Clarion Inc
- Health Services of Clarion, Inc.
- Hometown Oxygen Pittsburgh LLC
- Tara Lynn Keister
All providers in Fairmount City, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.