Madeline Gould

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA23151 Issued in CA

Practice address

565 N. Mount Vernon Ave
San Bernardino, CA 92411

Phone

(909) 884-9091

Fax

(909) 383-7013

NPI assigned

Sep 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: madeline.gould@403277232537604.direct.elationemr.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.

• Raincross Medical Group Inc

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1194712315
  Medicare reassignment

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1457786121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 N MOUNT VERNON AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924112661",
            "telephone_number": "909-884-9091",
            "fax_number": "909-383-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 N. MOUNT VERNON AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92411",
            "telephone_number": "909-884-9091",
            "fax_number": "909-383-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "MADELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA23151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Emrich Gort, LCSW
• Lynn Anna Gorton
• Gospha G, Campbell MD Inc
• Shalane Dominique Goss
• Ebony Gould
• Shannon Marie Goulmassian, RN, CNS
• Brenda Alejandra Govea
• Nadine Grace-Abraham, MD
• Del Grace
• Gracevine Healthcare SVCS a Professnal Nursing Corp

• Medical Physician Assistant in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.