Brooklynne F Goss, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61058272 Issued in WA

Practice address

101 NW 12TH Avenue
Suite 107
Battle Ground, WA 98604

Phone

(360) 723-0528

Fax

(360) 995-0081

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brooklynne Briana Ashley Frederick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2026 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: brooklynne.goss.1@18317.direct.athenahealth.com

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.

• Evergreen Women'S Health, PC

  • Gynecology Physician
  • Vancouver, WA
  • NPI 1467940726
  NPD (past)
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1346729696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVENUE",
            "address_2": "SUITE 107",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-723-0528",
            "fax_number": "360-995-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVENUE",
            "address_2": "SUITE 107",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-723-0528",
            "fax_number": "360-995-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSS",
        "first_name": "BROOKLYNNE",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61058272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161801",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKLYNNE",
            "last_name": "FREDERICK",
            "middle_name": "BRIANA ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Glenn, LMP
• Go Medical LLC
• Nathan Goins, PSYD
• Isabella Maria Demetro Gorini
• Lucia Karen Demetro Gorini
• Grace Greaves
• Jennifer E Griffis, RN
• Cambria Griffith, PA-C
• Heidi J Griggs, LMP
• Lynne Gropper-Baum, OTR/L

• Physician Assistant in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.