Individual provider Active NPI

Andrew C Gold, P.A.

  • Physician Assistant
  • Cleveland, TX
National Provider Identifier
1285956854
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06614 Issued in TX
Practice address
211 S College Ave
Cleveland, TX 77327-4503
Phone
(281) 592-8622
Fax
(281) 592-8699
NPI assigned
Feb 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA06614 TX Primary

Addresses

Primary practice location

211 S College Ave
Cleveland, TX 77327-4503

Mailing address

PO Box 5999
Kingwood, TX 77325-5999
Phone (281) 592-8622

Other identifiers 2

IdentifierTypeStateIssuer
76-0586988OtherTXTAX ID
PA06614OtherTXPA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000333 TX Practitioner - Physician Assistant 5496923914 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06614TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Medic Network, PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJAAAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/AJAAAA/Endpoint/AJAAAA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285956854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5999",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773255999",
            "telephone_number": "281-592-8622",
            "fax_number": "281-592-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S COLLEGE AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274503",
            "telephone_number": "281-592-8622",
            "fax_number": "281-592-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "ANDREW",
        "middle_name": "C",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "76-0586988",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA06614",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TX

Sources for this page

Verify at the official NPI Registry.