Active NPI
Mitchell Goza, PHARM. D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- West Allis, WI
National Provider Identifier
1295357572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 17898-40
- Practice address
- 2625 S 108TH St
West Allis, WI 53227-1931 - Phone
- (414) 328-4051
- NPI assigned
- May 10, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 17898-40 | WI | Primary |
Addresses
Primary practice location
2625 S 108TH St
West Allis, WI 53227-1931
Mailing address
2625 S 108TH St
West Allis, WI 53227-1931
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17898-40 | WI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589068800000",
"number": "1295357572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 S 108TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 S 108TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271931",
"telephone_number": "414-328-4051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOZA",
"first_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-10",
"last_updated": "2020-05-10",
"certification_date": "2020-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "WI",
"license": "17898-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.