Individual provider Active NPI

Edward L Golash, PA

  • Medical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1447258447
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001812 Issued in NY
Practice address
739 Irving Ave
Suite 500
Syracuse, NY 13210-1651
Phone
(315) 470-7409
Fax
(315) 475-2357
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001812 NY Primary

Addresses

Primary practice location

739 Irving Ave
Suite 500
Syracuse, NY 13210-1651

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 470-7409

Other identifiers 1

IdentifierTypeStateIssuer
01272646MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1812NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical Cardiovascular Group PC Current Accepting new patients
Crouse Medical Practice, PLLC Medical Past Accepting new patients

Locations

6221 State Route 31
Ste 104
Cicero, NY 13039
Phone (315) 698-4888

5100 W Taft Rd
#5J
Liverpool, NY 13088
Phone (315) 452-2014

5100 W Taft Rd
Ste 2J
Liverpool, NY 13088
Phone (315) 452-2220

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1447258447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-470-7409",
            "fax_number": "315-475-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 500",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101651",
            "telephone_number": "315-470-7409",
            "fax_number": "315-475-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLASH",
        "first_name": "EDWARD",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "001812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01272646",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.