NPIMap

Individual provider Active NPI

Matthew Robert Golish, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Clive, IA
National Provider Identifier
1861854374
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD-46778 Issued in IA
Practice address
12493 University Ave Ste 100
Clive, IA 50325-8286
Phone
(515) 358-9461
Fax
(515) 358-9489
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X MD-46778 IA Primary

Addresses

Primary practice location

12493 University Ave Ste 100
Clive, IA 50325-8286

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-9461

Other practice location 1

30 N 1900 E
1C301 Som
Salt Lake City, UT 84132-2119
Phone (801) 585-2589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826000929 IA Practitioner - Physical Medicine and Rehabilitation 4183980709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Maryland School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

12493 University Ave
Clive, IA 50325-8286

1401 Campus Dr
Clive, IA 50325-6500
Phone (515) 643-4915

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc CurrentSince Aug 19, 2020 Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 19, 2020 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

1401 Campus Dr
Des Moines, IA 50325
Phone (515) 381-6519

12493 University Ave
Ste 100
Des Moines, IA 50325
Phone (515) 358-0060

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1861854374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12493 UNIVERSITY AVE STE 100",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258286",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E",
            "address_2": "1C301 SOM",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841322119",
            "country_code": "US",
            "telephone_number": "801-585-2589",
            "fax_number": "801-587-7287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLISH",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IA",
            "license": "MD-46778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.