Jennifer W Gould, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35069468 Issued in OH

Practice address

2500 W Strub Rd
Suite 330
Sandusky, OH 44870-5390

Phone

(419) 626-6700

Fax

(419) 626-6710

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgould1@dermswohio.emadirect.md

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.

• Dermatologists of Southwestern Ohio, LLC.

  • Dermatology Physician
  • Dayton, OH
  • NPI 1801819883
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1851398507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W STRUB RD",
            "address_2": "SUITE 330",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705390",
            "telephone_number": "419-626-6700",
            "fax_number": "419-626-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W STRUB RD",
            "address_2": "SUITE 330",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705390",
            "telephone_number": "419-626-6700",
            "fax_number": "419-626-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35069468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2353215",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070012084",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000140612",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Gonzalez
• Marcia L Goodsite, LPCC
• Goodwill Industries of Erie, Huron, Ottawa & Sandusky Counties, Inc.
• Satya Srinivas Gorty, M.D.
• Karen Goshe, LISW-S
• Lynn Grant, COTA/L
• Lyric Grant
• Victoria Marie Grant
• David J Grayson, M.D.
• Great Direct Care LLC

• Dermatology Physician in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.