Organization Active NPI

Gerald M. Goltz, M.D. & Associates, PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Sewickley, PA
National Provider Identifier
1710206842
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD015354E Issued in PA
Legal business name
GERALD M. GOLTZ, M.D. & ASSOCIATES, PC
Practice address
701 Broad St
Suite C
Sewickley, PA 15143-1652
Phone
(412) 741-2552
Fax
(412) 741-9339
NPI assigned
May 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Authorized official

Name
Mrs. Marla A Reiter-Goltz, M.S.
Title
Ceo
Phone
(412) 716-7793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X MD015354E PA Primary

Addresses

Primary practice location

701 Broad St
Suite C
Sewickley, PA 15143-1652

Mailing address

701 Broad St
Suite C
Sewickley, PA 15143-1652
Phone (412) 741-2552

Other identifiers 1

IdentifierTypeStateIssuer
00753272MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110209000416 PA Part B Supplier - Clinic/Group Practice 3779763610 Receives reassigned benefits from 2 practitioners
Practice locations: Sewickley, PA

National Provider Directory

National Provider Directory

Locations

701 Broad St
Ste C
Sewickley, PA 15143
Phone (412) 741-2552

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1710206842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BROAD ST",
            "address_2": "SUITE C",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431652",
            "telephone_number": "412-741-2552",
            "fax_number": "412-741-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BROAD ST",
            "address_2": "SUITE C",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431652",
            "telephone_number": "412-741-2552",
            "fax_number": "412-741-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD M. GOLTZ, M.D. & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "REITER-GOLTZ",
        "authorized_official_first_name": "MARLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-716-7793",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD015354E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00753272",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewickley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.