Organization Active NPI

Michael J Gousy, OD LLC

  • Optometrist
  • Westfield, MA
National Provider Identifier
1396886479
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MICHAEL J GOUSY, OD LLC
Practice address
509 Southwick Rd
Westfield, MA 01085-4734
Phone
(413) 568-0180
Fax
(413) 642-6142
NPI assigned
Feb 9, 2007
Last updated
Dec 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Authorized official

Name
Michael Gousy, ODNPI 1689761561
Title
Owner
Phone
(413) 733-2318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

509 Southwick Rd
Westfield, MA 01085-4734

Mailing address

509 Southwick Rd
Westfield, MA 01085-4734
Phone (413) 568-0180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090311000022 MA Part B Supplier - Clinic/Group Practice 5294891693 Receives reassigned benefits from 1 practitioner
Practice locations: Monson, MA; Westfield, MA

National Provider Directory

National Provider Directory

Locations

120 Westfield St
West Springfield, MA 01089
Phone (413) 733-2318

180 Westfield St
West Springfield, MA 01089
Phone (413) 271-3056

194 E Main St
Westfield, MA 01085
Phone (413) 568-0180

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1396886479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 SOUTHWICK RD",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010854734",
            "telephone_number": "413-568-0180",
            "fax_number": "413-642-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SOUTHWICK RD",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010854734",
            "telephone_number": "413-568-0180",
            "fax_number": "413-642-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J GOUSY, OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "GOUSY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-733-2318",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.