Individual provider Active NPI

Mario Golocovsky, MD

  • Surgery Physician
  • Washington, DC
National Provider Identifier
1215928577
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD8978 Issued in DC
Practice address
110 Irving St NW
RM 4B39
Washington, DC 20010-2976
Phone
(202) 877-5190
Fax
(202) 877-3173
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD8978 DC Primary

Addresses

Primary practice location

110 Irving St NW
RM 4B39
Washington, DC 20010-2976

Mailing address

PO Box 418498
Boston, MA 02241-8498
Phone (703) 558-1544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000728 DC Practitioner - General SurgeryPractitioner - Vascular Surgery 9537117809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD8978DCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2019 Accepting new patients
WHC Physician Group LLC Surgery CurrentSince Aug 1, 2013 Accepting new patients
WHC Emerg Phys CurrentSince Aug 1, 2013 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Washington Metropolitan Practice Plan Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

106 Irving St NW
Ste 124
Washington, DC 20010
Phone (202) 877-2506

106 Irving St NW
#124S
Washington, DC 20010
Phone (202) 877-3785

110 Irving St NW
Rm 4B39
Washington, DC 20010
Phone (202) 877-5190

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

Organizations & group practices 6

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1215928577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418498",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418498",
            "telephone_number": "703-558-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "address_2": "RM 4B39",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102976",
            "telephone_number": "202-877-5190",
            "fax_number": "202-877-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOCOVSKY",
        "first_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "MD8978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.