Kerry Gomulka, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010206-1 Issued in NY

Practice address

30 Hatfield LN
Suite 101
Goshen, NY 10924-6766

Phone

(845) 294-2733

Fax

(845) 294-6486

NPI assigned

May 30, 2006

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

Other names 1

• Kerry Noetzel Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Horizon Medical Group PCGroup PAC ID 6103715529, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willcare Chha (Newburgh) Home health agency, Newburgh, NY, CCN 337408
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
• St Anthony Community Hospital Hospital, Warwick, NY, CCN 330205
• Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: kerry.gomulka@hfmg.eclinicaldirectplus.com

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.

• Horizon Medical Group, P.C.

  • Family Medicine Physician
  • Goshen, NY
  • NPI 1063488179
  Medicare reassignment Care Compare group
• Horizon Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Yorktown Heights, NY
  • NPI 1386520021
  NPD

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

• Bon Secours Community Hospital

  • General Acute Care Hospital
  • Port Jervis, NY
  • NPI 1659360709
  Care Compare affiliation
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• Litson Certified Care, Inc.

  • Home Health Agency
  • Newburgh, NY
  • NPI 1609926195
  Care Compare affiliation
• St. Anthony Community Hospital

  • General Acute Care Hospital
  • Warwick, NY
  • NPI 1598755324
  Care Compare affiliation

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1639126162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COATES DR",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246758",
            "telephone_number": "845-651-1400",
            "fax_number": "845-651-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HATFIELD LN",
            "address_2": "SUITE 101",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246766",
            "telephone_number": "845-294-2733",
            "fax_number": "845-294-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMULKA",
        "first_name": "KERRY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010206-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "NOETZEL",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Glen Arden, Inc.
• Catherine Werner Godwin, MS, CCC-SLP
• Christina Goebel
• Golden Promises Home Care LLC
• Alan Goldfischer, M.D.
• Cheyanne Elaine Gonzalez, LPN
• Elizabeth Gonzalez
• Georgina Gonzalez
• Jessica Gonzalez
• Karlee Anne Goode, PA-C

• Physician Assistant in Goshen, NY
• Providers in Goshen, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.
• 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.