Walter K Goljan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

52685 Issued in MA

Practice address

255 Park Ave
Suite 400
Worcester, MA 01609

Phone

(508) 755-9776

Fax

(508) 793-0715

NPI assigned

Feb 22, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in MA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Regal Medical Group

  • Family Medicine Physician
  • Westborough, MA
  • NPI 1083972806
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1619942679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "address_2": "SUITE 400",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01609",
            "telephone_number": "508-755-9776",
            "fax_number": "508-793-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "address_2": "SUITE 400",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01609",
            "telephone_number": "508-755-9776",
            "fax_number": "508-793-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLJAN",
        "first_name": "WALTER",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "52685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9768939",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Goldstein, RN
• Marc Solomon Goldstein, MD
• Dafna Leah Goldwasser
• Samantha Golemo, MA
• Douglas T Golenbock, M.D.
• Emi Golloshi
• Anne Golub-Victor, PT
• Joachim Gomes, CRNA
• Lavynya Gomes
• Leila Monteiro Gomes

• Internal Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.