Annette Michelle Golucke, CPNP-PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP03554 Issued in NM

Practice address

1512 N Zaragoza Rd Ste A1
El Paso, TX 79936-8903

Phone

(915) 855-7700

NPI assigned

Jan 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM, TX2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: annette.golucke@direct.myhealthep.org

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.

• Longhorn Emergency Medical Associates PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1649669672

  Nurse Practitioner

  Medicare reassignment NPD
• Southwest Emergency Medical Associates of NM PC

  • Emergency Medicine Physician
  • Las Cruces, NM
  • NPI 1720505571

  Nurse Practitioner

  Medicare reassignment NPD
• Pediatric Group of Central El Paso

  • Pediatric Adolescent Medicine Physician
  • El Paso, TX
  • NPI 1962435370
  NPD (past)
• Topcare Medical Group Inc

  • Specialist
  • Dallas, TX
  • NPI 1730337163
  NPD (past)

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1871091876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W JOHN CARPENTER FWY STE 420",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392014",
            "telephone_number": "972-957-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 N ZARAGOZA RD STE A1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799368903",
            "telephone_number": "915-855-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUCKE",
        "first_name": "ANNETTE",
        "middle_name": "MICHELLE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP135944",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "CNP-03554",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP03554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "659321YRND",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49451821",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Golder, FNP
• Edward Mark Goldman, M.D.
• Gordon Goldsmith, M.D.
• Paul Goldstein, PH.D.
• Randy J. Goldstein, M.D.
• Reagan Golucke
• Sarika Gomez Cantrell, MS CCC/SLP
• Miroslava Gomez Hurtado
• Angelica Gomez Plascencia
• Ana Maria Gomez Samaniego, PT

• Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.