Denise Ann Gomolak, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP1123 Issued in AZ

Practice address

107 E Oak Ave
Flagstaff, AZ 86001-1818

Phone

(928) 913-8800

Fax

(928) 913-8801

NPI assigned

Aug 31, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oneida Indian Health ServicesGroup PAC ID 9133254584, 9 clinicians

Psychiatry Faculty Practice, IncGroup PAC ID 9234458530, 90 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.28 of 100Reported as group

Quality

88.2

Promoting interoperability

100

Improvement activities

40

Cost

69.72

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dgomolak133472@direct.upstate.edu

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.

• Psychiatry Faculty Practice, Inc.

  • Psychiatry Physician
  • Syracuse, NY
  • NPI 1881084820
  Medicare reassignment Care Compare group NPD
• Oneida Indian Health Services

  • Federally Qualified Health Center (FQHC)
  • Oneida, NY
  • NPI 1831196716
  Care Compare group

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881705804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OAK AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011818",
            "telephone_number": "928-913-8800",
            "fax_number": "928-913-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMOLAK",
        "first_name": "DENISE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "510829",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP1123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910514",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910514",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerry Ann Golden, PT
• Karen Golowenski, RN
• Patricia Ann Golson, LMT
• Christopher Luis Gomez, APRN
• Thelma Gomez
• Hope J Gonzales, RBT
• Ashley Gonzalez Medrano
• Oscar Gonzalez
• Goodwill of Northern Arizona
• Nicole Elise Goodwin, FNP-BC

• Family Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.