Individual provider Active NPI

Audrey Goh

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1972274280
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP272440 Issued in AZ
Practice address
612 W Baseline Rd
Mesa, AZ 85210-6041
Phone
(480) 834-9039
NPI assigned
Sep 26, 2021
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RNP272440 AZ Primary
Critical Care Medicine Registered Nurse 163WC0200X RN200291 AZ

Addresses

Primary practice location

612 W Baseline Rd
Mesa, AZ 85210-6041

Mailing address

612 W Baseline Rd
Mesa, AZ 85210-6041
Phone (480) 834-9039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, 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

Enrollment IDStateProvider typePAC IDDetails
I20220531000782 AZ Practitioner - Nurse Practitioner 4587042767 Reassigns benefits to 1 organization
I20241217000663 TX Practitioner - Nurse Practitioner 4587042767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Desert Kidney Associates PLCGroup PAC ID 4284611286, 27 clinicians

Practice addresses (Care Compare)

612 W Baseline Rd
Mesa, AZ 85210-6041
Phone (480) 834-9039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN200291AZMDCritical Care Medicine Registered Nurse
RNP272440AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Kidney Associates PLC CurrentSince Apr 1, 2022 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care Corporation CurrentSince Nov 14, 2024 Accepting new patients
Gila River Health Care CurrentSince Nov 14, 2024 Accepting new patients
Bio-Medical Applications of Arizona, LLC Past Accepting new patients

Locations

1828 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6738

5200 E Cortland Blvd
Ste A4
Flagstaff, AZ 86004
Phone (928) 527-4990

3511 S Mercy Rd
Ste 101
Gilbert, AZ 85297
Phone (480) 857-8338

6724 S Kings Ranch Rd
Ste 104
Gold Canyon, AZ 85118
Phone (480) 982-3337

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

612 W Baseline Rd
Mesa, AZ 85210
Phone (310) 940-4170

3124 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 371-4700

22715 S Ellsworth Rd
Bldg G
San Tan Valley, AZ 85142
Phone (480) 677-2463

10450 E Riggs Rd
Ste 110
Sun Lakes, AZ 85248
Phone (480) 895-7600

2022 E Prince Rd
Tucson, AZ 85719
Phone (520) 327-0007

Interoperability endpoints

  • Direct secure messaging: agoh41570@direct.acumenmd.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1632614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1972274280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106041",
            "telephone_number": "480-834-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106041",
            "telephone_number": "480-834-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOH",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-26",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP272440",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AZ",
            "license": "RN200291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.