Individual provider Active NPI

Elihu Goretsky, MFT

  • Marriage & Family Therapist
  • Vista, CA
National Provider Identifier
1689767113
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
46560 Issued in CA
Practice address
3048 Overhill Dr
Vista, CA 92084-6551
Phone
(818) 636-0745
Fax
(760) 295-1763
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 46560 CA Primary

Addresses

Primary practice location

3048 Overhill Dr
Vista, CA 92084-6551

Mailing address

3048 Overhill Dr
Vista, CA 92084-6551
Phone (818) 636-0745

Other names 1

  • Mr. Eliott Goretsky Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260203002371 CA Practitioner - Marriage and Family Therapist 1759869423 Practice locations: Vista, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Vista, CA 92084
Phone (818) 636-0745

3048 Overhill Dr
Vista, CA 92084-6551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46560CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Octave Behavioral Health PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1689767113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 OVERHILL DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846551",
            "telephone_number": "818-636-0745",
            "fax_number": "760-295-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 OVERHILL DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846551",
            "telephone_number": "818-636-0745",
            "fax_number": "760-295-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORETSKY",
        "first_name": "ELIHU",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIOTT",
            "last_name": "GORETSKY",
            "prefix": "MR.",
            "credential": "MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.