PENNY GOUMENIDIS PA-C
NPI 1063115137
Physician Assistant in Modesto, CA

Q: What is Penny Goumenidis's NPI number?

The NPI number for Penny Goumenidis is 1063115137. It was assigned to this individual provider in the NPPES registry on March 27, 2023.

Q: What is Penny Goumenidis's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Penny Goumenidis was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 27, 2023PECOS EnrolledAccepts Medicare Assignment

1441 FLORIDA AVE, MODESTO, CA 95350(209) 578-1211 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 16, 2023, Mar 27, 2023 (2 updates tracked since 2023).

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About Penny Goumenidis Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNY GOUMENIDIS PA-C (NPI 1063115137) is an individual physician assistant in Modesto, California, licensed in California (62524) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1063115137

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NamePENNY GOUMENIDISCredential: PA-C

Location Address1441 FLORIDA AVEModesto, CA 95350-4404

Mailing Address425 Dellbrook AveSouth San Francisco, CA 94080-1231

Phone(209) 578-1211

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMarch 27, 2023

Last NPPES UpdateMay 16, 20232 updates tracked since enumeration

NPPES CertifiedMay 16, 2023

✔ NPI 1063115137 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · 62524

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1441 FLORIDA AVE, Modesto, CA 95350

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Penny Goumenidis Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587020136

PECOS Enrollment IDI20230524000706

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95350 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$73.16 typical visit price

range $19.28 – $144.60

Typical copayment $18.29 (range $4.82 – $36.15)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THUY-LIEN THI LE M.D.

Student in an Organized Health Care Education/Training Program