Active NPI
Gregory Lee Goetz, D.O.
- Anesthesiology Physician
- Las Vegas, NV
National Provider Identifier
1659406304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 1182
- Practice address
- 9260 W Sunset Rd
Ste. 200
Las Vegas, NV 89148-4858 - Phone
- (702) 255-3547
- Fax
- (702) 921-2419
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 1182 | NV | Primary |
Addresses
Primary practice location
9260 W Sunset Rd
Ste. 200
Las Vegas, NV 89148-4858
Mailing address
645 E Missouri Ave
Ste 300
Phoenix, AZ 85012-1351
Phone (602) 262-8917
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100504861 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 5, 2024 through Jun 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1182 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1659406304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 E MISSOURI AVE",
"address_2": "STE 300",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121351",
"telephone_number": "602-262-8917",
"fax_number": "602-262-8890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9260 W SUNSET RD",
"address_2": "STE. 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891484858",
"telephone_number": "702-255-3547",
"fax_number": "702-921-2419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETZ",
"first_name": "GREGORY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NV",
"license": "1182",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100504861",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.