Tatiana A. Goclowski, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12.007735 Issued in CT

Practice address

187 Beacon Rd
Bethany, CT 06524-3054

Phone

(413) 388-2892

NPI assigned

Mar 3, 2017

Last updated

Jun 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Radiology & Imaging Inc

  • Diagnostic Radiology Physician
  • Springfield, MA
  • NPI 1790731008
  NPD (past)

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1831639392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WASON AVE STE 120",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071179",
            "telephone_number": "413-241-2100",
            "fax_number": "413-735-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 BEACON RD",
            "city": "BETHANY",
            "state": "CT",
            "postal_code": "065243054",
            "telephone_number": "413-388-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCLOWSKI",
        "first_name": "TATIANA",
        "middle_name": "A.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN231763",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.007735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Diotalevi, DMD
• Deborah Lynn Ellsworth, LCSW
• Michael Bruce Enson, MSW LCSW
• William Fischer, M.D.
• Ashlee Fuoco-Abate
• Grassylane Therapies, LLC
• Michael Sean Harris, PH.D., M.DIV.
• Anthony Hebert Hebert
• Lasharon Hernandez, APRN PMHNP
• Infinite Well LLC

• Family Nurse Practitioner in Bethany, CT
• Providers in Bethany, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.