Individual provider Active NPI

Joseph Goyzman, AUD., CCC-A

  • Audiologist
  • Vancouver, WA
National Provider Identifier
1598850455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD00002576 Issued in WA
Practice address
1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644
Phone
(360) 256-4425
Fax
(360) 260-7249
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X LD00002576 WA Primary

Addresses

Primary practice location

1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644

Mailing address

1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644
Phone (360) 256-4425

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825001499 WA Practitioner - Qualified Audiologist 5395719124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

417 SE 164TH Ave
Suite 300
Vancouver, WA 98684-8944
Phone (360) 256-4425

505 NE 87TH Ave
Vancouver, WA 98664-1965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jan 23, 2017 Accepting new patients
Peacehealth CurrentSince Jan 23, 2017 Accepting new patients
Peacehealth Past Accepting new patients

Locations

1801 1st Ave
Ste 3A
Longview, WA 98632
Phone (360) 256-4425

625 9th Ave
Ste 120
Longview, WA 98632
Phone (360) 425-3720

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

1405 SE 164th Ave
Ste 102
Vancouver, WA 98683
Phone (360) 253-4405

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598850455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-260-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-260-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYZMAN",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "AUD., CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD00002576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.