Paul Sanford Pickholtz, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD49699 Issued in TN

Practice address

7557 Dannaher Dr
Suite 130
Powell, TN 37849-3558

Phone

(865) 859-7330

Fax

(865) 859-7339

NPI assigned

Aug 21, 2006

Last updated

Apr 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 4, 2025 through Apr 4, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paul S Pickholtz MD PC

  • Gastroenterology Physician
  • Yonkers, NY
  • NPI 1396929402
  NPD (past) Authorized official
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Ronceverte Physician Group LLC

  • Gastroenterology Physician
  • Ronceverte, WV
  • NPI 1306170048
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1568578979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7557 DANNAHER DR",
            "address_2": "SUITE 130",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493558",
            "telephone_number": "865-859-7330",
            "fax_number": "865-859-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7557 DANNAHER DR",
            "address_2": "SUITE 130",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493558",
            "telephone_number": "865-859-7330",
            "fax_number": "865-859-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKHOLTZ",
        "first_name": "PAUL",
        "middle_name": "SANFORD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "MD49699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV0682A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "3810011422",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01203321",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn E Pendergast, OT
• Erica Jaquise Peppers, MPH, B.A.
• Monica Perry, O.D.
• Raheel Perveez, MBBS
• Amelia Peterson, CD-L
• Amy Pierce, AU.D.
• Pippin Dental Care Odd, LLC
• Laura Gustafson Porter, PHD
• Powell Counseling Center, PLLC
• Powell Dentistry, PLLC

• Gastroenterology Physician in Powell, TN
• Providers in Powell, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.