Individual provider Active NPI

Andrew Joseph Golniewicz

  • Podiatrist
  • Dyer, IN
National Provider Identifier
1649768045
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
135001247 Issued in IL
Practice address
24 Joliet St
Dyer, IN 46311-1705
Phone
(708) 341-3889
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 135001247 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

24 Joliet St
Dyer, IN 46311-1705

Mailing address

24 Joliet St
Dyer, IN 46311-1705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
135001247ILMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1649768045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111705",
            "telephone_number": "708-341-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLNIEWICZ",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "135001247",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.