Individual provider Active NPI

Joanna P Goll, NP

  • Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1578617650
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
499016 Issued in CA
Practice address
5805 Sepulveda Blvd
Suite 610
Van Nuys, CA 91411-2546
Phone
(818) 908-8048
Fax
(818) 908-8072
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 499016 CA Primary

Addresses

Primary practice location

5805 Sepulveda Blvd
Suite 610
Van Nuys, CA 91411-2546

Mailing address

12660 Riverside Dr
Suite 225
North Hollywood, CA 91607-3429
Phone (818) 487-0040

Other identifiers 1

IdentifierTypeStateIssuer
499016OtherCASTATE LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000168 CA Practitioner - Nurse Practitioner 2769547710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-Valley Pulmonary Medical Group, Inc.Group PAC ID 8325029143, 10 clinicians
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 502
Sherman Oaks, CA 91403-1817
Phone (818) 325-0200

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
499016CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Dec 6, 2014 Accepting new patients
Valley Internal Medicine & Nephrology Medical Group Past Accepting new patients
Yaroslav a. Gofnung, M.D., Inc. Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

12660 Riverside Dr
Ste 225
North Hollywood, CA 91607
Phone (818) 487-0040

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jgoll208791@direct.cshs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1578617650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "address_2": "SUITE 225",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-487-0040",
            "fax_number": "818-487-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 SEPULVEDA BLVD",
            "address_2": "SUITE 610",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112546",
            "telephone_number": "818-908-8048",
            "fax_number": "818-908-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLL",
        "first_name": "JOANNA",
        "middle_name": "P",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "499016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "499016",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.