NPIMap

Organization Active NPI

Golan Integrated Physical Medicine

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Las Vegas, NV
National Provider Identifier
1497195580
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
Legal business name
GOLAN INTEGRATED PHYSICAL MEDICINE
Practice address
6592 N Decatur Blvd
Suite 115
Las Vegas, NV 89131-1037
Phone
(702) 478-9594
Fax
(702) 478-9509
NPI assigned
Jul 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
David Robert Golan, MDNPI 1457441206
Title
Medical Doctor
Phone
(808) 463-9726

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204C00000X NV Primary

Addresses

Primary practice location

6592 N Decatur Blvd
Suite 115
Las Vegas, NV 89131-1037

Mailing address

PO Box 561564
Denver, CO 80256-1564
Phone (702) 202-1850

Other identifiers 1

IdentifierTypeStateIssuer
6983960001OtherNVPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131126001716 NV Part B Supplier - Clinic/Group Practice 2365678125 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
Practice locations: Henderson, NV; Las Vegas, NV
O20190327001607 NV DME Supplier - Physician - Physical and RehabilitationDME Supplier - Physician - Chiropractic 2365678125 Practice locations: Las Vegas, NV

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2770 S Maryland Pkwy
Ste 200
Las Vegas, NV 89109
Phone (702) 478-9594

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1497195580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561564",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802561564",
            "telephone_number": "702-202-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6592 N DECATUR BLVD",
            "address_2": "SUITE 115",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891311037",
            "telephone_number": "702-478-9594",
            "fax_number": "702-478-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLAN INTEGRATED PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "GOLAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "808-463-9726",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6983960001",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.