Individual provider Active NPI

Patrick Edward Goldsmith, PA-C

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1811391006
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1208097 Issued in NC
Practice address
Marine Staff Services 1775 Forrestal Drive BLDG 41
Norfolk, VA 23551-0001
Phone
(910) 581-0065
NPI assigned
Oct 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1208097 NC Primary

Addresses

Primary practice location

Marine Staff Services 1775 Forrestal Drive BLDG 41
Norfolk, VA 23551-0001

Mailing address

Medical Staff Services 1775 Forrestal Drive Blvd 41
Norfolk, VA 23551-0001
Phone (910) 581-0065

Other practice location 1

165 I St. Bldg. HP 402
Camp Lejeune, NC 28547
Phone (910) 581-0065

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417002136 NC Practitioner - Physician Assistant 8820513286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1208097NCMDPhysician Assistant

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": "1413417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1811391006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL STAFF SERVICES 1775 FORRESTAL DRIVE BLVD 41",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235510001",
            "telephone_number": "910-581-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARINE STAFF SERVICES 1775 FORRESTAL DRIVE BLDG 41",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235510001",
            "telephone_number": "910-581-0065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 I St. Bldg. HP 402",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "28547",
            "country_code": "US",
            "telephone_number": "910-581-0065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-16",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1208097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.