Individual provider Active NPI

Paul S. Goggi Jr., MSW

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1609884964
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PRO20904-1 Issued in NY
Practice address
2100 E Genesee St
Syracuse, NY 13210-2249
Phone
(315) 422-9717
Fax
(315) 422-9718
NPI assigned
Aug 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Mental Health Counselor 101YM0800X PRO20904-1 NY Primary

Addresses

Primary practice location

2100 E Genesee St
Syracuse, NY 13210-2249

Mailing address

2100 E Genesee St
Syracuse, NY 13210-2249
Phone (315) 422-9717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000243 NY Practitioner - Clinical Social Worker 5991980351 Practice locations: Syracuse, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Alabama School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2100 E Genesee St
Syracuse, NY 13210-2249
Phone (315) 422-9717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PRO20904-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609884964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102249",
            "telephone_number": "315-422-9717",
            "fax_number": "315-422-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102249",
            "telephone_number": "315-422-9717",
            "fax_number": "315-422-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGGI",
        "first_name": "PAUL",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "PRO20904-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.