Individual provider Active NPI

Michael Gorski, D.O.

  • Family Medicine Physician
  • Saint Charles, IA
National Provider Identifier
1699747444
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03050 Issued in IA
Practice address
101 E Main St
Saint Charles, IA 50240-1522
Phone
(641) 396-2255
Fax
(641) 396-2655
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 03050 IA Primary

Addresses

Primary practice location

101 E Main St
Saint Charles, IA 50240-1522

Mailing address

101 E Main St
Saint Charles, IA 50240-1522
Phone (641) 396-2255

Other identifiers 1

IdentifierTypeStateIssuer
0144006MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20040907000704 IA Practitioner - Emergency MedicinePractitioner - Family Practice 5991771495 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
03050IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clarke County Public Hospital Family Medicine Past Accepting new patients
Madison County Memorial Hospital Past Accepting new patients
Emcare Physician Providers Inc. Past Accepting new patients

Organizations & group practices 4

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1699747444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "city": "SAINT CHARLES",
            "state": "IA",
            "postal_code": "502401522",
            "telephone_number": "641-396-2255",
            "fax_number": "641-396-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "city": "SAINT CHARLES",
            "state": "IA",
            "postal_code": "502401522",
            "telephone_number": "641-396-2255",
            "fax_number": "641-396-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORSKI",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144006",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, IA

Sources for this page

Verify at the official NPI Registry.