Individual provider Active NPI

Carol D. Gold, ANP

  • Adult Health Nurse Practitioner
  • Peekskill, NY
National Provider Identifier
1407959737
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F303207 Issued in NY
Practice address
1037 Main St
Hudson River Healthcare, Inc.
Peekskill, NY 10566-2913
Phone
(914) 734-8800
Fax
(914) 734-8808
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F303207 NY Primary

Addresses

Primary practice location

1037 Main St
Hudson River Healthcare, Inc.
Peekskill, NY 10566-2913

Mailing address

1037 Main St
Hudson River Healthcare, Inc.
Peekskill, NY 10566-2913
Phone (914) 734-8800

Other identifiers 2

IdentifierTypeStateIssuer
02919579MedicaidNY
00473038MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000231 NY Practitioner - Nurse Practitioner 0042244352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F303207NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Dec 1, 2014 Accepting new patients
Sun River Health Inc Current Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

1037 Main St
Peekskill, NY 10566
Phone (914) 734-8800

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1407959737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 MAIN ST",
            "address_2": "HUDSON RIVER HEALTHCARE, INC.",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662913",
            "telephone_number": "914-734-8800",
            "fax_number": "914-734-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 MAIN ST",
            "address_2": "HUDSON RIVER HEALTHCARE, INC.",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662913",
            "telephone_number": "914-734-8800",
            "fax_number": "914-734-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "CAROL",
        "middle_name": "D.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02919579",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peekskill, NY

Sources for this page

Verify at the official NPI Registry.