Individual provider Active NPI

Gerald Golner, MD

  • Pediatric Adolescent Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1407947047
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
5814 Issued in AZ
Practice address
6702 N 19TH Ave
Phoenix, AZ 85015-1101
Phone
(602) 242-5121
Fax
(602) 242-6945
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 5814 AZ Primary

Addresses

Primary practice location

6702 N 19TH Ave
Phoenix, AZ 85015-1101

Mailing address

4434 N 12TH Street
Phoenix, AZ 85014-1101
Phone (602) 242-5121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090309000173 AZ Practitioner - Pediatric Medicine 7911085634 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Pediatrics LTD CurrentSince Nov 22, 2008 Accepting new patients
North Scottsdale Pediatric Associates Past Accepting new patients

Locations

4434 N 12th St
Phoenix, AZ 85014
Phone (602) 242-5121

6702 N 19th Ave
Phoenix, AZ 85015
Phone (602) 242-5121

4735 E Union Hills Dr
Phoenix, AZ 85050
Phone (602) 242-5121

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1407947047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4434 N 12TH STREET",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850141101",
            "telephone_number": "602-242-5121",
            "fax_number": "602-242-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6702 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151101",
            "telephone_number": "602-242-5121",
            "fax_number": "602-242-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLNER",
        "first_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AZ",
            "license": "5814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.