Robert Matthew Golden, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001633-01 Issued in NY

Practice address

69 Lakewood CT Apt 18
Moriches, NY 11955-2016

Phone

(631) 690-0471

NPI assigned

Oct 19, 2023

Last updated

Oct 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1811779234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 LAKEWOOD CT APT 18",
            "city": "MORICHES",
            "state": "NY",
            "postal_code": "119552016",
            "telephone_number": "631-690-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 LAKEWOOD CT APT 18",
            "city": "MORICHES",
            "state": "NY",
            "postal_code": "119552016",
            "telephone_number": "631-690-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "ROBERT",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "001633-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Moriches, NY
• Providers in Moriches, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.