Jillian Genevieve Goles, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4631 Woodland Corporate Blvd
Tampa, FL 33614-2442

Phone

(410) 960-9108

NPI assigned

May 1, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1487189221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 40TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337144415",
            "telephone_number": "410-960-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 WOODLAND CORPORATE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142442",
            "telephone_number": "410-960-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLES",
        "first_name": "JILLIAN",
        "middle_name": "GENEVIEVE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Stuart Goldstein, M.D.
• Robert J Goldstein, M.D.
• Stacey P Goldstein, O.D.
• Synthia Goldstein
• Aldo Alexis Goldsztein Perez
• Ernest Dennis Golin, ATC,LMT,CSTS
• Nicholas Gollab
• John Gollery
• Alena Golubkova
• Anthony Fitzgerald Gomes, M.D.

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.