Vanessa L Goldbach, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103811 Issued in FL

Practice address

2441 Oak Myrtle LN Ste 101
Wesley Chapel, FL 33544-6334

Phone

(813) 406-4835

Fax

(813) 994-4835

NPI assigned

Dec 26, 2007

Last updated

Aug 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Vanessa Lewis Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Orlando Cancer Center Inc

  dba MD Anderson Cancer Center Orlando

  • Medical Oncology Physician
  • Orlando, FL
  • NPI 1578510582
  NPD (past)

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1477737526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 OAK MYRTLE LN STE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446334",
            "telephone_number": "813-406-4835",
            "fax_number": "813-994-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 OAK MYRTLE LN STE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446334",
            "telephone_number": "813-406-4835",
            "fax_number": "813-994-4835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7040 Land O Lakes Blvd",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346383204",
            "country_code": "US",
            "telephone_number": "813-406-4835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3610 Galileo Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Trinity",
            "state": "FL",
            "postal_code": "346551794",
            "country_code": "US",
            "telephone_number": "813-406-4835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBACH",
        "first_name": "VANESSA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9103811",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292973200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y0K5Q",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "LEWIS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Global Synergy Healthcare
• Bailey Elizabeth Glover
• Michael A. Godfrey, LPN
• Michelle Lee Goff, PA-C
• Carson Wright Goins, RDN
• Daniella Goldenberg, MD, MS
• Danielle Gomez, APRN
• Gabriela Gomez, DENTAL LAB TECH
• Jesus Ivan Gonzalez Batista, APRN
• Eduardo Cesar Gonzalez Cernadas, ARNP

• Physician Assistant in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.