Individual provider Active NPI

Dan Gozhansky, M.D.

  • Emergency Medicine Physician
  • Lakeway, TX
National Provider Identifier
1346401999
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N9558 Issued in TX
Practice address
100 Medical Parkway
Lakeway, TX 78734
Phone
(301) 346-7594
NPI assigned
Jun 17, 2008
Last updated
Jan 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT193105 PA
Emergency Medicine Physician 207P00000X N9558 TX Primary

Addresses

Primary practice location

100 Medical Parkway
Lakeway, TX 78734

Mailing address

208 San Marcos St
Austin, TX 78702-4248
Phone (301) 346-7594

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110907001043 TX Practitioner - Emergency Medicine 6002086758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longhorn Emergency Medical Associates PAGroup PAC ID 4486971041, 149 clinicians

Practice addresses (Care Compare)

2000 Scenic Dr
Georgetown, TX 78626-7726
Phone (512) 943-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT193105PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Apr 17, 2017 Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

Organizations & group practices 1

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1346401999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SAN MARCOS ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024248",
            "telephone_number": "301-346-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARKWAY",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "78734",
            "telephone_number": "301-346-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZHANSKY",
        "first_name": "DAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT193105",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N9558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

Verify at the official NPI Registry.