Active NPI
James Peter Goetz, M.D.
- Pediatrics Physician
- Brockport, NY
National Provider Identifier
1336183318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 136458-1
- Practice address
- 300 West Ave
Brockport, NY 14420-1118 - Phone
- (585) 637-3905
- Fax
- (585) 637-4990
- NPI assigned
- Jun 16, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 136458-1 | NY | Primary |
Addresses
Primary practice location
300 West Ave
Brockport, NY 14420-1118
Mailing address
300 West Ave
Brockport, NY 14420-1118
Phone (585) 637-3905
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00464397 | Medicaid | NY | |
| 9681866 | Other | NY | MVP SELECT CARE |
| 000526031001 | Other | NY | INDEPENDENT HEALTH |
| 5651454 | Other | NY | AETNA HMO/PPO/POS |
| 000010902030 | Other | NY | FIDELIS |
| 100842DL | Other | NY | PREFERRED CARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136458-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1336183318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 WEST AVE",
"city": "BROCKPORT",
"state": "NY",
"postal_code": "144201118",
"telephone_number": "585-637-3905",
"fax_number": "585-637-4990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WEST AVE",
"city": "BROCKPORT",
"state": "NY",
"postal_code": "144201118",
"telephone_number": "585-637-3905",
"fax_number": "585-637-4990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETZ",
"first_name": "JAMES",
"middle_name": "PETER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "136458-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00464397",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP SELECT CARE",
"identifier": "9681866",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "000526031001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO/PPO/POS",
"identifier": "5651454",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "000010902030",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "100842DL",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.