Active NPI
Carl Stephen Goetz, MD
- Dermatology Physician
- Carmichael, CA
National Provider Identifier
1235169707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G32226
- Practice address
- 6401 Coyle Avenue
#315
Carmichael, CA 95608 - Phone
- (916) 966-6444
- Fax
- (916) 966-9077
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G32226 | CA | Primary |
| Dermatopathology Physician | 207ND0900X | G32226 | CA | |
| Clinical & Laboratory Dermatological Immunology Physician | 207NI0002X | G32226 | CA | |
| Pediatric Dermatology Physician | 207NP0225X | G32226 | CA | |
| Procedural Dermatology Physician | 207NS0135X | G32226 | CA |
Addresses
Primary practice location
6401 Coyle Avenue
#315
Carmichael, CA 95608
Mailing address
6401 Coyle Avenue
#315
Carmichael, CA 95608
Phone (916) 966-6444
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G322260 | Medicaid | CA | |
| 00G322261 | Other | CA | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G32226 | CA | MD | Dermatopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1235169707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 COYLE AVENUE",
"address_2": "#315",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "95608",
"telephone_number": "916-966-6444",
"fax_number": "916-966-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6401 COYLE AVENUE",
"address_2": "#315",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "95608",
"telephone_number": "916-966-6444",
"fax_number": "916-966-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETZ",
"first_name": "CARL",
"middle_name": "STEPHEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G32226",
"primary": true
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "CA",
"license": "G32226",
"primary": false
},
{
"code": "207NI0002X",
"taxonomy_group": "",
"desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
"state": "CA",
"license": "G32226",
"primary": false
},
{
"code": "207NP0225X",
"taxonomy_group": "",
"desc": "Dermatology, Pediatric Dermatology",
"state": "CA",
"license": "G32226",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "CA",
"license": "G32226",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G322260",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "00G322261",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.