Robert John Goelz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5000898 Issued in WI

Practice address

1052 Bel Aire CT
Green Bay, WI 54304-5015

Phone

(920) 499-8711

Fax

(920) 499-9903

NPI assigned

Jan 14, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 11, 2016 through May 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821149253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 BEL AIRE CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045015",
            "telephone_number": "920-499-8711",
            "fax_number": "920-499-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 BEL AIRE CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045015",
            "telephone_number": "920-499-8711",
            "fax_number": "920-499-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOELZ",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5000898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33541100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Gnabasik, PMHNP
• Eric James Goddeyne, PA-C
• Steven Godfrey
• Andrew S. Godin, PA-C
• Marcy L Godlewski, NP
• Marsha Jane Smits Goffard, OTR
• Hannah Gohde
• Sheila K Gohr, LPC, APSW
• Demet Gokalp Yasar, M.D.
• Jamie E Gokey, CRNA

• General Practice Dentistry in Green Bay, WI
• Providers in Green Bay, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.