MR. JON GOOTNICK (NPI# 1578506515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578506515 |
| Entity Type | Individual |
| Full Name | MR. JON GOOTNICK |
| Credential | PA |
| Practice Address |
10 Clinton Pl Fairport NY 14450-2426 |
| Practice Telephone | 5852235737 |
| Mailing Telephone | 5852235737 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
002056 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10 CLINTON PL |
| City | FAIRPORT |
| State | NY |
| Zip Code | 14450-2426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982255899 | Stephanie Janet Catlin-rakoski | Counselor | 1387 Fairport Rd Bldg 500, Ste 540, Fairport, NY 14450 | 2019-09-23 |
| 1477011773 | Meredith Noel Austin-appleton | Pediatrics | Pediatric Urgent Care of Rochester, 6687 Pittsford Palmyra Rd, Fairport, NY 14450 | 2019-03-05 |
| 1659852358 | Linda Demme | Registered Nurse | 29 Pleasant St, Fairport, NY 14450 | 2018-08-22 |
| 1679075154 | Tharaha Thavakumar | Behavior Technician | 6 N. Main Street, Fairport, NY 14450 | 2018-03-01 |
| 1295244309 | Comprehensive Medicine, Pllc | Psychiatry & Neurology | 762 Crosskeys Office Park, Fairport, NY 14450 | 2017-09-21 |
| 1104353846 | Courtney Chapman | Student in an Organized Health Care Education/Training Program | 4 Valais Ct, Fairport, NY 14450 | 2017-05-12 |
| 1477947786 | Preston Orthodontics, Pllc | Dentist | 2154 Fairport Nine Mile Point Road, Fairport, NY 14450 | 2015-03-25 |
| 1154724334 | Amanda Corrisa Kalsih | Registered Nurse | 95 Evergreen Circle, Fairport, NY 14450 | 2014-10-02 |
| 1295172153 | Pamela Lea Alexander | Skilled Nursing Facility | 41 O,connor Road, Monroe #1 Boces, Fairport, NY 14450 | 2013-05-31 |
| 1255682084 | Lauren Lashomb | Specialist | 6 North Main Street, Fairport, NY 14450 | 2012-09-19 |
| Find all providers in zip 14450 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434727 | Julia Loren Bartsch | Physician Assistant | 11791 Genesee St, Alden, NY 14004-9713 | 2020-10-16 |
| 1295347078 | Alana Janine Miller | Physician Assistant | 1060 5th Ave # 1b, New York, NY 10128-0104 | 2020-08-21 |
| 1336768647 | Abul Sarker | Physician Assistant | 2 Sagamore Ave, Suffern, NY 10901-7412 | 2020-04-16 |
| 1689200412 | Margaret Ann Sullivan | Physician Assistant | 7011 108th St Apt 4l, Forest Hills, NY 11375-4407 | 2020-03-12 |
| 1376177527 | Anabell Marina Lopez Plaza | Physician Assistant | 12 Berrywood Ct, Bay Shore, NY 11706-2058 | 2020-02-26 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1831736602 | Ll Physician Assistant PC | Physician Assistant | 2279 Coney Island Ave Fl 2, Brooklyn, NY 11223-3337 | 2019-11-29 |
| 1992348775 | Nafiur Rahman Chowdhury | Physician Assistant | 8268 164th St Rm A3-65, Jamaica, NY 11432-1121 | 2019-10-23 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1578114377 | Matthew Newmark Eisenstein | Physician Assistant | 3260 43rd St Apt 2r, Astoria, NY 11103-2745 | 2019-09-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.