Individual provider Active NPI

Ann Marie Goth

  • Social Worker
  • Madison, WI
National Provider Identifier
1467111658
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
130539-121 Issued in WI
Practice address
25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone
(608) 280-2700
NPI assigned
Dec 15, 2021
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 130539-121 WI Primary

Addresses

Primary practice location

25 Kessel CT Ste 105
Madison, WI 53711-6227

Mailing address

25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314002254 WI Practitioner - Clinical Social Worker 7810361821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130539-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jul 24, 2023 Accepting new patients

Locations

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1467111658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTH",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130539-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.