Individual provider Active NPI

Joseph P Gowaty, PA-C

  • Surgical Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1508843616
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110002228 Issued in VA
Practice address
4117 Plank Rd
Fredericksburg, VA 22407-4888
Phone
(540) 785-8018
Fax
(888) 398-9051
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110002228 VA Primary

Addresses

Primary practice location

4117 Plank Rd
Fredericksburg, VA 22407-4888

Mailing address

4117 Plank Rd
Fredericksburg, VA 22407-4888
Phone (540) 785-8018

Other identifiers 1

IdentifierTypeStateIssuer
4330530001OtherDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20221110000176 VA Practitioner - Physician Assistant 9830170521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Active Orthopedic Health and Wellness LLC CurrentSince Aug 2, 2022 Accepting new patients
Watauga Orthopaedics PLC Past Accepting new patients
Mary Washington Healthcare Physicians Past Accepting new patients

Locations

4117 Plank Rd
Fredericksburg, VA 22407
Phone (540) 785-8018

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.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1508843616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074888",
            "telephone_number": "540-785-8018",
            "fax_number": "888-398-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074888",
            "telephone_number": "540-785-8018",
            "fax_number": "888-398-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWATY",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4330530001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.