Nicole Goult, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F352053-01 Issued in NY

Practice address

7851 Brewerton Rd # 1
Cicero, NY 13039-9533

Phone

(315) 484-5809

NPI assigned

Jun 16, 2023

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

Enrolled in NY

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

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

On Care Family Health NP PLLCGroup PAC ID 9931507969, 6 clinicians

Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.goult.1@24958.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/24958/brand/1/csg/1/fhir/r4

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.

• On Care Family Health NP, PLLC

  • Nurse Practitioner
  • Manlius, NY
  • NPI 1043981814
  Medicare reassignment Care Compare group NPD
• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162
  Medicare reassignment Care Compare group NPD
• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Jamestown, NY
  • NPI 1770850224
  NPD (past)

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1558046557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 HOGSBACK RD",
            "city": "HASTINGS",
            "state": "NY",
            "postal_code": "130764104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7851 BREWERTON RD # 1",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399533",
            "telephone_number": "315-484-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULT",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F352053-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Ganser, LDO
• Charbel Ghosn, DMD
• Erika J Glasso, BC-HIS
• Emily Glisson, NP
• Wendy Gorman
• Great Auk DME LLC
• Great Auk Healthcare Connect
• Great Northern Optical Equipment Inc.
• Karen Greene
• Todd M Greer, PHARMACY TECH

• Family Medicine Physician in Cicero, NY
• Providers in Cicero, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.