Individual provider Active NPI

Jose Fernando Aycinena Goicolea, MD

  • Colon & Rectal Surgery Physician
  • Gainesville, GA
National Provider Identifier
1245495787
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
076114 Issued in GA
Practice address
725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone
(770) 536-2323
Fax
(770) 536-4947
NPI assigned
Jul 24, 2008
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 076114 GA
Colon & Rectal Surgery Physician 208C00000X 076114 GA Primary

Addresses

Primary practice location

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other practice location 1

1270 Friendship Rd
Braselton, GA 30517-5608
Phone (770) 536-2323

Other practice location 2

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 536-2323

Other practice location 3

1400 River Pl
Braselton, GA 30517-5600
Phone (770) 536-2323

Other practice location 4

495 Highway 400
Dahlonega, GA 30533-6823
Phone (770) 536-2323

Other names 1

  • Jose Fernando Aycinena Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20161027000980 GA Practitioner - Colorectal Surgery (Proctology) 0345411906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3854
Phone (770) 533-6511

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 533-6511

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 533-6511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy150
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
076114GAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic PC CurrentSince Oct 1, 2016 Accepting new patients
The Longstreet Clinic, PC Surgery CurrentSince Oct 1, 2016 Accepting new patients
Northeast Georgia Community Physicians LLC CurrentSince Feb 1, 2026 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Northeast Georgia Medical Center, Inc. Past Accepting new patients

Locations

1270 Friendship Rd
Braselton, GA 30517
Phone (678) 207-4200

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

495 Highway 400
Dahlonega, GA 30533
Phone (469) 757-1107

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Interoperability endpoints

  • Direct secure messaging: fernando.aycinena@longstreetclinic.gadirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1245495787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-536-2323",
            "fax_number": "770-536-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175608",
            "country_code": "US",
            "telephone_number": "770-536-2323",
            "fax_number": "770-536-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-536-2323",
            "fax_number": "770-536-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-536-2323",
            "fax_number": "770-536-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 Highway 400",
            "address_purpose": "LOCATION",
            "city": "Dahlonega",
            "state": "GA",
            "postal_code": "305336823",
            "country_code": "US",
            "telephone_number": "770-536-2323",
            "fax_number": "770-536-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYCINENA GOICOLEA",
        "first_name": "JOSE",
        "middle_name": "FERNANDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-24",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "076114",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "076114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "AYCINENA",
            "middle_name": "FERNANDO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.