Samantha Gomolka, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

01763 Issued in WV

Practice address

3045 Southwestern Blvd Ste 104
Orchard Park, NY 14127

Phone

(716) 675-7000

Fax

(716) 674-4659

NPI assigned

Nov 19, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: samantha.gomolka@988519603109892.direct.elationemr.com

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1619307121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 SOUTHWESTERN BLVD STE 104",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271209",
            "telephone_number": "716-675-7000",
            "fax_number": "716-674-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 SOUTHWESTERN BLVD STE 104",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-675-7000",
            "fax_number": "716-674-4659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5187 US Route 60 Ste 11",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257052076",
            "country_code": "US",
            "telephone_number": "304-399-5437",
            "fax_number": "304-399-1104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMOLKA",
        "first_name": "SAMANTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Godwin
• Nadine Gogan, CRC
• Gabriel Joan Golabek, PMHNP-BC
• Jeffrey A Goldstein, MD
• Henry Frederick Goller, M.D.
• Gail R Goodman, M.D.
• Julie Diane Goodspeed, DC
• Catherine M Goodwyn
• Dawn Elizabeth Gorczyca, MS SP ED, CAS ADMIN,
• Lynn Ann Gorczyca

• Medical Physician Assistant in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.