Individual provider Active NPI

Harry David Goldwasser, MD

  • Psychiatry Physician
  • Big Bear Lake, CA
National Provider Identifier
1255370680
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G132642 Issued in CA
Practice address
41870 Garstin Dr
Big Bear Lake, CA 92315-2088
Phone
(909) 878-8246
Fax
(909) 746-4304
NPI assigned
Jun 4, 2006
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G132642 CA Primary
Addiction Psychiatry Physician 2084P0802X 132642 CA

Addresses

Primary practice location

41870 Garstin Dr
Big Bear Lake, CA 92315-2088

Mailing address

5510 Roberts Rd
Yucca Valley, CA 92284-2168
Phone (520) 237-0757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150716001424 CA Practitioner - Psychiatry 7315901733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Alabama School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bear Valley Community Health Care DistrictGroup PAC ID 0345138582, shared by 3 NPIs, 28 clinicians

Practice addresses (Care Compare)

PO Box
Big Bear Lake, CA 92315-1649

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20842AZMDSocial Worker
G132642CAMDPsychiatry Physician
132642CAMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Tribal Health Southshore Clinic CurrentSince Jul 1, 2024 Accepting new patients
Lake County Tribal Health Consortium Inc. CurrentSince Jul 1, 2024 Accepting new patients
Magellan Health Services of Arizona, Inc Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients

Locations

14440 Olympic Dr
Clearlake, CA 95422
Phone (707) 263-8382

925 Bevins Ct
Lakeport, CA 95453
Phone (707) 263-8382

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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 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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1255370680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 ROBERTS RD",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842168",
            "telephone_number": "520-237-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41870 GARSTIN DR",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923152088",
            "telephone_number": "909-878-8246",
            "fax_number": "909-746-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDWASSER",
        "first_name": "HARRY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G132642",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "132642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Bear Lake, CA

Sources for this page

Verify at the official NPI Registry.