Samuel K Gooldy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

135438 Issued in NY

Practice address

1 Oxford Rd
Suite 304
New Hartford, NY 13413-2651

Phone

(315) 724-6611

Fax

(315) 724-6366

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wynn Hospital Hospital, Utica, NY, CCN 330044

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drgooldy@skgmd.medentdirect.com

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.

• Samuel K Gooldy, MD PC

  • Family Medicine Physician
  • New Hartford, NY
  • NPI 1104975036
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MVHS Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  Care Compare affiliation

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225187164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OXFORD RD",
            "address_2": "SUITE 304",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132651",
            "telephone_number": "315-724-6611",
            "fax_number": "315-724-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OXFORD RD",
            "address_2": "SUITE 304",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132651",
            "telephone_number": "315-724-6611",
            "fax_number": "315-724-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLDY",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "135438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00582774",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis Golis, RPAC
• Justin-Theodore Hunter Gondeck, PHARMD
• Barbara Brooks Goodman, MSW
• Daniel C. Goodman, M.D.
• David Nicholas Goodman
• Julie Gorczynski, PA
• Alexis Gordon
• Darcy Gorski
• Nathaniel S Gould, M.D.
• Julia Elizabeth Grant, PH.D.

• Family Medicine Physician in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.