Active NPI
Ilya Golovaty, M.D.
- Internal Medicine Physician
- Seattle, WA
National Provider Identifier
1497173371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A148806
- Practice address
- 1660 S Columbian Way
Seattle, WA 98108-1532 - Phone
- (206) 764-2936
- NPI assigned
- Mar 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | A148806 | CA | Primary |
Addresses
Primary practice location
1660 S Columbian Way
Seattle, WA 98108-1532
Mailing address
1660 S Columbian Way
Seattle, WA 98108-1532
Other practice location 1
1959 NE Pacific St Rm Bb-527
Box 356421
Seattle, WA 98195-6421
Phone (206) 543-3605
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A148806 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of California SFGH Medical Group | Current | Accepting new patients | |
| University of California SFGH Medical Group | Current | Accepting new patients | |
| University of California SFGH Medical Group | Internal Medicine | Current | Accepting new patients |
Locations
1001 Potrero Ave
Bldg 51M
San Francisco, CA 94110
1001 Potrero Ave
Rm 5H22
San Francisco, CA 94110
Phone (628) 206-4774
Organizations & group practices 3
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.
-
- Otolaryngology Physician
- San Francisco, CA
- NPI 1154396208
-
- Vascular Surgery Physician
- San Francisco, CA
- NPI 1033913959
-
- Geriatric Medicine (Internal Medicine) Physician
- San Francisco, CA
- NPI 1659626257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586390400000",
"number": "1497173371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-764-2936"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St Rm Bb-527",
"address_2": "Box 356421",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981956421",
"country_code": "US",
"telephone_number": "206-543-3605",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLOVATY",
"first_name": "ILYA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-28",
"last_updated": "2020-04-09",
"certification_date": "2020-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A148806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.