NPIMap

Individual provider Active NPI

Frederick Goll III, M.D.

  • Otolaryngology Physician
  • Henderson, NV
National Provider Identifier
1316904253
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
7728 Issued in NV
Practice address
3195 Saint Rose Pkwy
Suite 210
Henderson, NV 89052-3501
Phone
(702) 792-6700
Fax
(702) 792-7198
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 7728 NV Primary

Addresses

Primary practice location

3195 Saint Rose Pkwy
Suite 210
Henderson, NV 89052-3501

Mailing address

3195 Saint Rose Pkwy
Suite 210
Henderson, NV 89052-3501
Phone (702) 792-6700

Other identifiers 1

IdentifierTypeStateIssuer
2002895MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041119001034 NV Practitioner - Otolaryngology 6507821469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Iowa, RJ & L Carver College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear, Nose and Throat Consultants of NevadaGroup PAC ID 9032105952, 15 clinicians

Practice addresses (Care Compare)

3195 Saint Rose Pkwy
Suite 210
Henderson, NV 89052-3504
Phone (702) 792-6700

3195 St Rose Parkway
Suite 210
Henderson, NV 89052-3504

8840 W Sunset Rd
Suite a
Las Vegas, NV 89148-4897
Phone (702) 792-6700

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045

Merit-based Incentive Payment System (MIPS)

Final score
81.75 of 100Reported as individual
Quality
67.37
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Consultants of Nevada CurrentSince Feb 26, 2009 Accepting new patients
Ear Nose and Throat Surgery Center LLC Current Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Henderson Hospital Past Accepting new patients
Desert View Regional Medical Center Holdings, LLC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Ear Nose & Throat Specialists of Nevada Otolaryngology Past Accepting new patients

Locations

3195 Saint Rose Pkwy
Ste 210
Henderson, NV 89052
Phone (702) 792-6700

7040 Smoke Ranch Rd
Las Vegas, NV 89128
Phone (702) 792-6700

8840 W Sunset Rd
#B
Las Vegas, NV 89148
Phone (702) 209-3377

8840 W Sunset Rd
#A
Las Vegas, NV 89148
Phone (702) 792-6700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 22

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 22

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1316904253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 SAINT ROSE PKWY",
            "address_2": "SUITE 210",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523501",
            "telephone_number": "702-792-6700",
            "fax_number": "702-792-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 SAINT ROSE PKWY",
            "address_2": "SUITE 210",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523501",
            "telephone_number": "702-792-6700",
            "fax_number": "702-792-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLL",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NV",
            "license": "7728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002895",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.