Individual provider Active NPI

Matthew Gold

  • Dentist
  • Circleville, OH
National Provider Identifier
1861848830
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.24715 Issued in OH
Practice address
915 S Court St
Circleville, OH 43113-2178
Phone
(740) 334-4116
NPI assigned
May 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.24715 OH Primary

Addresses

Primary practice location

915 S Court St
Circleville, OH 43113-2178

Mailing address

11349 Terwilligers Valley LN
Cincinnati, OH 45249-2745

Other identifiers 1

IdentifierTypeStateIssuer
1811170160MedicaidOH

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210202002134 OH Order and Referring Only - DentistPractitioner - Dentist 7719391754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.24715OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Circleville Dental Partner Past Accepting new patients
Naylor Dental LLC Dentist Past Accepting new patients

Organizations & group practices 2

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1861848830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11349 TERWILLIGERS VALLEY LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S COURT ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431132178",
            "telephone_number": "740-334-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.24715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811170160",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

Verify at the official NPI Registry.